The Increasing Prevalence of Atrial Fibrillation among Hemodialysis Patients

被引:222
作者
Winkelmayer, Wolfgang C. [1 ,2 ]
Patrick, Amanda R. [2 ]
Liu, Jun [2 ]
Brookhart, M. Alan [2 ,3 ]
Setoguchi, Soko [2 ,4 ]
机构
[1] Stanford Univ, Sch Med, Div Nephrol, Palo Alto, CA 94304 USA
[2] Harvard Univ, Brigham & Womens Hosp, Sch Med, Div Pharmacoepidemiol & Pharmacoecon, Boston, MA 02115 USA
[3] Univ N Carolina, Gillings Sch Global Publ Hlth, Chapel Hill, NC USA
[4] Duke Univ, Sch Med, Duke Clin Res Inst, Durham, NC USA
来源
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY | 2011年 / 22卷 / 02期
关键词
RISK-FACTORS; DIALYSIS PATIENTS; HEART-FAILURE; UNITED-STATES; SURVIVAL; MORTALITY; POPULATION; OUTCOMES; STROKE; EPIDEMIOLOGY;
D O I
10.1681/ASN.2010050459
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
A half million Americans have ESRD, which puts them at high risk for cardiovascular disease and poor outcomes. Little is known about the epidemiology of atrial fibrillation among patients with ESRD. We analyzed data from annual cohorts (1992 to 2006) of prevalent hemodialysis patients from the United States Renal Data System. In each cohort, we searched 1 year of medical claims for relevant diagnosis codes to determine the prevalence of atrial fibrillation. Among 2.5 million patient observations, 7.7% had atrial fibrillation, with the prevalence increasing 3-fold from 3.5% (1992) to 10.7% (2006). The number of affected patients increased from 3620 to 23,893 (6.6-fold) during this period. Older age, male gender, and several comorbid conditions were associated with increased risk for atrial fibrillation. Compared with otherwise similar Caucasians, the prevalence of atrial fibrillation rates was substantially lower for blacks, Asians, and Native Americans. One-year mortality was twice as high among hemodialysis patients with atrial fibrillation compared with those without (39% versus 19%), and this increased risk was constant during the 15 years of the study. In conclusion, the prevalence of diagnosed atrial fibrillation among patients receiving hemodialysis in the United States is increasing, varies by race, and remains associated with substantially increased mortality. Identifying potentially modifiable risk factors for incident atrial fibrillation requires further investigation.
引用
收藏
页码:349 / 357
页数:9
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