Reduced GFR Associated With Increased Atrial Fibrillation Risk

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Across categories of increasing UACR there was a step-wise increase in the adjusted risk of incident AF.
Across categories of increasing UACR there was a step-wise increase in the adjusted risk of incident AF.

HealthDay News — Reduced estimated glomerular filtration rate (eGFR) and elevated urine albumin-to-creatinine ratio (UACR) are associated with increased risk of incident atrial fibrillation (AF), according to research published in the Clinical Journal of the American Society of Nephrology.

Nisha Bansal, MD, from the University of Washington in Seattle, and colleagues conducted a meta-analysis of 3 prospective cohorts (16,769 participants) to examine the correlation of eGFR and UACR with the risk of incident AF.

The researchers found that across categories of decreasing eGFR, there was a step-wise increase in the adjusted risk of incident AF, with hazard ratios of 1.00, 1.09 (95% confidence interval [CI], 0.97 to 1.24), 1.17 (95% CI, 1.00 to 1.38), 1.59 (95% CI, 1.28 to 1.98), and 2.03 (95% CI, 1.40 to 2.96), for eGFR >90 (reference), 60 to 89, 45 to 59, 30 to 44, and <30 ml/min/1.73 m², respectively. 

Across categories of increasing UACR there was a step-wise increase in the adjusted risk of incident AF, with hazard ratios of 1.00, 1.04 (95%  CI, 0.83 to 1.30), 1.47 (95% CI, 1.20 to 1.79), and 1.76 (95% CI, 1.18 to 2.62), respectively, for UACR <15 (reference), 15 to 29, 30 to 299, and ≥300 mg/g, respectively.

"These data highlight the need for further studies to examine the mechanistic link between kidney disease and AF," the authors write.

Bansal N, Zelnick LR, Benjamin EJ, et al. eGFR and albuminuria in relation to risk of incident atrial fibrillation: a meta-analysis of the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study. Clin J Am Soc Nephrol. 2017 Aug 10. pii: CJN.01860217.

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