Document Detail


Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study.
MedLine Citation:
PMID:  19781424     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Atrial fibrillation (AF) and chronic kidney disease share risk factors and pathophysiologic mechanisms, suggesting that two conditions have close relationships. METHODS: This is a prospective community-based observational cohort study including 235,818 subjects based upon a voluntary annual health check-up program in Japan. We studied the association of kidney dysfunction at entry with subsequent new-onset AF and the association of AF at entry with the development of kidney disease. RESULTS: During a follow-up of 5.9 +/- 2.4 years, AF developed in 2947 subjects (1.3%). Baseline serum creatinine and estimated glomerular filtration rate (GFR) were associated with risk of subsequent AF. The HRs (95% CI) for AF were 1.32 (1.08-1.62) and 1.57 (0.89-2.77) for GFR 30 to 59 and <30 mL/min per 1.73 m(2), respectively. The effect of kidney disease on risk of new-onset AF remained significant in subjects without treated hypertension or diabetes. During the follow-up, 7791 subjects (3.3%) developed kidney dysfunction (GFR <60 mL/min per 1.73 m(2)), and 11 307 subjects (4.9%) developed proteinuria. Atrial fibrillation at entry was associated with development of kidney dysfunction (HRs [95% CI], 1.77 [1.50-2.10]) and proteinuria (HR [95% CI], 2.20 [1.92-2.52]). The association persisted in subjects without treated hypertension or diabetes. CONCLUSIONS: Kidney dysfunction increased the risk of new onset of AF, and AF increased the risk of development of kidney disease. This finding supports the concept that the two conditions share common abnormal molecular signaling pathways contributing to their pathogenesis.
Authors:
Hiroshi Watanabe; Toru Watanabe; Shigeru Sasaki; Kojiro Nagai; Dan M Roden; Yoshifusa Aizawa
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  158     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-09-28     Completed Date:  2009-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  629-36     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan. hiroshi.watanabe@vanderbilt.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / epidemiology,  etiology*,  prevention & control
Female
Follow-Up Studies
Glomerular Filtration Rate / physiology
Heart Rate / physiology
Humans
Incidence
Japan / epidemiology
Kidney Failure, Chronic / complications*,  epidemiology,  physiopathology
Male
Mass Screening / methods*
Middle Aged
Prognosis
Prospective Studies
Risk Assessment
Risk Factors
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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