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Morbidity and treatment in patients with atrial fibrillation and chronic kidney disease.
MedLine Citation:
PMID:  24897032     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality but there are few studies available about atrial fibrillation, the most frequent arrhythmia in CKD, and the applied treatment. Based on the prospective German Competence NETwork on Atrial Fibrillation, data of 3138 patients with atrial fibrillation were analyzed and categorized by their estimated glomerular filtration rate (stages 1-3 and 4 plus 5). With advanced CKD, significantly more patients suffered from a more severe form of atrial fibrillation. Despite significantly higher CHADS2 scores in advanced CKD, oral anticoagulation was not prescribed more frequently while antiarrhythmic drugs and catheter ablations were used significantly less often, in contrast to more pacemaker implantations. However, in multivariate hierarchical logistic regression analyses of in-hospital treatments and complications, only hemorrhages and pacemaker implantations turned out to be independently and significantly associated with higher CKD stages. This nationwide study shows that patients with CKD and atrial fibrillation suffer from a markedly higher comorbidity. Thus, while CKD patients have received cardioversions, ablations, antiarrhythmic, or anticoagulation drugs significantly less often in their history, current treatments were not different if adjusted for multiple comorbidities. This might indicate an improvement in the often reported therapeutic nihilism in CKD.Kidney International advance online publication, 4 June 2014; doi:10.1038/ki.2014.195.
Authors:
Holger Reinecke; Michael Nabauer; Andrea Gerth; Tobias Limbourg; Andras Treszl; Christiane Engelbertz; Lars Eckardt; Paulus Kirchhof; Karl Wegscheider; Ursula Ravens; Thomas Meinertz; Gerhard Steinbeck; Günter Breithardt
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-04
Journal Detail:
Title:  Kidney international     Volume:  -     ISSN:  1523-1755     ISO Abbreviation:  Kidney Int.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0323470     Medline TA:  Kidney Int     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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