Association of Chronic Kidney Disease With Atrial Fibrillation in the General Adult Population: A Nationwide Population-Based Study

被引:19
作者
Kim, Seon-Mi [1 ]
Jeong, Yujin [2 ]
Kim, Yae Lim [2 ]
Kang, Minjung [1 ]
Kang, Eunjeong [3 ]
Ryu, Hyunjin [1 ]
Kim, Yunmi [4 ]
Han, Seung Seok [1 ]
Ahn, Curie [5 ]
Oh, Kook-Hwan [1 ,6 ]
机构
[1] Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea
[2] Korea Univ, Dept Biostat, Coll Med, Seoul, South Korea
[3] Ewha Womans Univ, Seoul Hosp, Dept Internal Med, Coll Med, Seoul, South Korea
[4] Inje Univ, Dept Internal Med, Busan Paik Hosp, Busan, South Korea
[5] Natl Med Ctr, Dept Internal Med, Seoul, South Korea
[6] Seoul Natl Univ, Dept Internal Med, Med Coll, 101 Daehakro, Seoul 03080, South Korea
来源
JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2023年 / 12卷 / 08期
基金
新加坡国家研究基金会;
关键词
atrial fibrillation; chronic kidney disease; incidence; nationwide cohort; RISK-FACTORS; PREVALENCE; EPIDEMIOLOGY; ATHEROSCLEROSIS; CLASSIFICATION; MANAGEMENT; MECHANISMS;
D O I
10.1161/JAHA.122.028496
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
BackgroundThe incidences of atrial fibrillation (AF) and chronic kidney disease (CKD) are increasing, and AF is prevalent in patients with CKD. However, few studies have investigated the incidence or association of AF in a large CKD population from a longitudinal study. Methods and ResultsFrom a nationwide cohort, a total of 4 827 987 Korean individuals without prior AF, who received biennial health checkups provided by the National Health Insurance Service between 2009 and 2012 in Korea, were analyzed. Incidence of AF was ascertained through the end of 2018. During a median follow-up of 8.1 years, the annual incidence rate of AF was 1.17 per 1000 person-years among subjects without CKD, 1.55 for stage 1 CKD, 1.86 for stage 2 CKD, 2.1 for stage 3 CKD, and 4.33 for stage 4 CKD. In Fine-Gray regression models, CKD was associated with an increased risk of AF; the adjusted hazard ratios and 95% CIs of AF occurrence were 1.77 (1.69-1.85), 1.85 (1.80-1.91), 1.99 (1.95-2.04), and 4.04 (3.07-5.33) in individuals with CKD stages 1, 2, 3, and 4, respectively, compared with non-CKD. The association between CKD and incident AF remained statistically significant after adjustment for multiple confounding factors and was consistent across subgroups stratified by sex and age. ConclusionsCKD is associated with an increased incidence of AF. Even mild CKD is associated with incident AF, and there was a stepwise increase in the risk of incident AF with a decrease in renal function.
引用
收藏
页数:14
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