Clinical InvestigationElectrophysiologyChronic kidney disease and prevalent atrial fibrillation: The Chronic Renal Insufficiency Cohort (CRIC)
Section snippets
Study population
The CRIC study is a prospective cohort of 3,612 participants with CKD. The study design and methods21 as well as the baseline cohort characteristics22 have been described elsewhere. Briefly, 7 clinical centers recruited adults who were aged 21 to 74 years and had CKD (but were not on dialysis) using age-based estimated glomerular filtration rate(eGFR) inclusion criteria (eGFR of 20 to 70, 60, or 50 mL/[min 1.73 m2] for age ranges 21-44, 45-64 and 65-74 years, respectively). Informed consent was
Results
Among the 3,267 participants included in this analysis, 1,627 were non-Hispanic white and 1,640 were non-Hispanic black (Table I). Mean age was 58.6 years, and 46% were women. More than 86% were hypertensive, 45% were diabetic, and 34% had a self-reported history of cardiovascular disease. The mean eGFR was 43.6 ±13.4 mL/(min 1.73 m2); approximately 55% of the study population had an eGFR <45 mL/(min 1.73 m2).
AF was present in 602 (18%) participants (Table II). Most AF cases were detected by
Discussion
This study addressed the prevalence and correlates of prevalent AF in a well-defined multiracial cohort of US individuals with CKD who are not receiving long-term dialysis treatments. Most of the previous studies that examined associations between AF and CKD were conducted either in ESRD patients on dialysis or in a general population sample, or were restricted to a single racial/ethnic group.10, 11, 12, 13, 32, 33 Our study revealed 3 main findings. First, the prevalence of AF was high in this
Acknowledgements
We thank the CRIC participants, staff, and investigators for their contributions to CRIC study.
References (51)
- et al.
Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a retrospective analysis of the SOLVD trials. Studies of Left Ventricular Dysfunction
J Am Coll Cardiol
(1998) - et al.
Incidence of atrial fibrillation in whites and African-Americans: the Atherosclerosis Risk in Communities (ARIC) study
Am Heart J
(2009) - et al.
Influence of atrial fibrillation on the morbido-mortality of patients on hemodialysis
Am Heart J
(2000) - et al.
Prevalence of atrial fibrillation and associated factors in a population of long-term hemodialysis patients
Am J Kidney Dis
(2005) - et al.
Long-term evolution of cardiomyopathy in dialysis patients
Kidney Int
(1998) - et al.
Insulin resistance and hyperinsulinemia are already present in patients with incipient renal disease
Kidney Int
(1998) - et al.
Cardiovascular disease in patients with chronic kidney disease: getting to the heart of the matter
Am J Kidney Dis
(2001) - et al.
Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study
Am Heart J
(2009) - et al.
Relation of atrial fibrillation to glomerular filtration rate
Am J Cardiol
(2008) - et al.
Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort study
Lancet
(2009)
Racial variation in the prevalence of atrial fibrillation among patients with heart failure: the Epidemiology, Practice, Outcomes, and Costs of heart failure (EPOCH) study.
J Am Coll Cardiol
Atrial fibrillation at baseline and during follow-up in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)
J Am Coll Cardiol.
Risk of stroke in non-rheumatic atrial fibrillation
Lancet
Inflammation, endothelial dysfunction, and platelet activation in patients with chronic kidney disease: the chronic renal impairment in Birmingham (CRIB) study
Am J Kidney Dis
Interleukin-6 predicts hypoalbuminemia, hypocholesterolemia, and mortality in hemodialysis patients
Am J Kidney Dis
Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study)
Am J Cardiol
Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study
JAMA
Impact of atrial fibrillation on the risk of death: the Framingham Heart Study
Circulation
Impact of atrial fibrillation on mortality, stroke, and medical costs
Arch Intern Med
Atrial fibrillation and dementia in a population-based study. The Rotterdam Study
Stroke
Clinical characteristics associated to atrial fibrillation in chronic hemodialysis patients
Clin Nephrol
Ethnic distribution of electrocardiographic predictors of atrial fibrillation and its impact on understanding the ethnic distribution of ischemic stroke in the Atherosclerosis Risk in Communities Study (ARIC)
Stroke
The sensitivity of the methods of detection of atrial fibrillation in population studies affects group-specific prevalence estimates: ethnic and regional distribution of atrial fibrillation in REGARDS study
J Epidemiol
Atrial fibrillation in dialysis patients
Nephrol Dial Transplant
Symptomatic atrial arrhythmias in hemodialysis patients
Ren Fail
Cited by (368)
Comparative Safety and Effectiveness of Warfarin or Rivaroxaban Versus Apixaban in Patients With Advanced CKD and Atrial Fibrillation: Nationwide US Cohort Study
2024, American Journal of Kidney DiseasesKidney Function, Albuminuria, and Risk of Incident Atrial Fibrillation: A Systematic Review and Meta-Analysis
2024, American Journal of Kidney DiseasesDifference Between Estimated GFR Based on Cystatin C Versus Creatinine and Incident Atrial Fibrillation: A Cohort Study of the UK Biobank
2024, American Journal of Kidney Diseases