NN&I Article – As kidney function decreases, risk for AFib increases

As kidney function decreases, risk for AFib increases


A new study published in the Clinical Journal of the American Society of Nephrology indicates that individuals with kidney disease have a higher risk of developing atrial fibrillation, or an irregular heartbeat.

Nisha Bansal, MD, MAS from the University of Washington, and her colleagues analyzed the results of three prospective studies: the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study.

In the analysis of 16,769 community-dwelling individuals without atrial fibrillation, there was a step-wise increase in the risk of incident atrial fibrillation with decreasing kidney function. In patients with the lowest kidney function or the greatest amount of proteinuria, the risk for developing atrial fibrillation was approximately two-fold higher compared with those without kidney disease.

This link held even after accounting for a wide range of possible contributors, including measures of cardiovascular health, and it was consistent across subgroups of participants categorized by age, sex, race, and comorbidity.

“This study found that even modest abnormalities in kidney function were linked with a higher risk of developing atrial fibrillation later in life,” said Bansal. “Atrial fibrillation may affect the selection of cardiovascular therapies and is associated with poor clinical outcomes. Thus, an understanding of the risk of atrial fibrillation across a broad range of kidney function is important.”

Dr. Bansal noted that additional studies are needed to determine the mechanistic link between kidney disease and atrial fibrillation.

Study co-authors include Leila Zelnick, PhD, Alvaro Alonso, MD, Emelia Benjamin, MD, ScM, Ian de Boer, MD, MS Rajat Deo, MD, Ronit Katz, DPhil, Bryan Kestenbaum, MD, MS, Jehu Mathew, MD, Cassianne Robinson-Cohen, PhD, Mark Sarnak, MD, MS, Michael Shlipak, MD, MPH, Nona Sotoodehnia, MD, MPH, Bessie Young, MD, MPH, and Susan Heckbert, MD, PhD.

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It has been Nichole Jefferson‘s personal mission to tell her story and promote awareness. She was diagnosed with end-stage renal disease (ESRD) in October 2003. At that time, not only was she unaware of what that meant; she also did not know she was a high-risk factor for developing the disease.
After the initial shock of the diagnosis, she decided peritoneal dialysis (PD) was the best option and utilized PD for a few years until she needed to switch to hemodialysis.
She received a kidney transplant from a deceased donor on June 12, 2008, but at the time, she didn’t realize it was simply another form of treatment and not a cure. Today, Nichole is waiting for a new transplant.
Nichole has worked with many advocacy groups on Capitol Hill and has provided her personal experience with ESRD to leaders in the field of nephrology. She tries to express the feelings of those who are unable or unwilling to speak for themselves.