Document Detail


Prevalence of atrial fibrillation and associated factors in a population of long-term hemodialysis patients.
MedLine Citation:
PMID:  16253730     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Hemodialysis (HD) is associated with cardiovascular structural modifications; moreover, during HD, rapid electrolytic changes occur. Both factors may favor the onset of atrial fibrillation. METHODS: To define the prevalence of atrial fibrillation and identify associated factors, 488 patients on long-term HD therapy (age, 66.6 +/- 13.4 years; men, 58.0%; duration of HD, 76.5 +/- 84.3 months) were studied. RESULTS: Atrial fibrillation was reported in 27.0% of patients; paroxysmal in 3.5%, persistent in 9.6%, and permanent in 13.9%. Clinical and echocardiographic variables were considered: patients with atrial fibrillation were older (71.8 +/- 9.3 versus 64.7 +/- 14.2 years; P < 0.01), and its prevalence increased with age. Patients with arrhythmia had a longer duration of dialysis therapy (93.2 +/- 100.5 versus 70.2 +/- 76.7 months; P = 0.02). Atrial fibrillation was associated significantly with ischemic heart disease (P < 0.01), dilated cardiomyopathy (P < 0.01), acute pulmonary edema (P < 0.05), valvular disease (P < 0.05), cerebrovascular accidents (P < 0.05), and predialytic hyperkalemia (P < 0.05). Patients with atrial fibrillation more frequently showed left atrial dilatation (59.8% versus 34.5%; P < 0.0001), and in these subjects, left ventricular ejection fraction was significantly lower (53.9% versus 57.4%; P = 0.029). No association was found between arrhythmia and hypertension or diabetes. Multivariate analysis confirmed that patient age (P < 0.001), duration of HD therapy (P = 0.001), and left atrial dilatation (P < 0.001) were associated with atrial fibrillation. CONCLUSION: Atrial fibrillation is much more frequent in HD patients than in the general population; age, duration of HD history, presence of some heart diseases, and left atrial dilatation are associated with the arrhythmia.
Authors:
Simonetta Genovesi; Daniela Pogliani; Andrea Faini; Maria G Valsecchi; Alessandra Riva; Francesca Stefani; Irene Acquistapace; Andrea Stella; Giuseppe Bonforte; Amedeo DeVecchi; Vincenzo DeCristofaro; Gherardo Buccianti; Antonio Vincenti
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  46     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-10-28     Completed Date:  2005-11-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  897-902     Citation Subset:  IM    
Affiliation:
Dipartimento di Medicina Clinica Prevenzione e Biotecnologie Sanitarie, Università degli Studi Milano, Bicocca, Italy. simonetta.genovesi@unimib.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Aged, 80 and over
Atrial Fibrillation / epidemiology*,  etiology,  ultrasonography
Cohort Studies
Comorbidity
Cross-Sectional Studies
Diabetes Complications / epidemiology
Disease Susceptibility
Female
Heart Atria / pathology
Heart Diseases / epidemiology
Humans
Hyperkalemia / epidemiology
Italy / epidemiology
Kidney Failure, Chronic / complications,  epidemiology*,  therapy
Male
Middle Aged
Myocardial Ischemia / epidemiology
Prevalence
Pulmonary Disease, Chronic Obstructive / epidemiology
Pulmonary Edema / epidemiology
Renal Dialysis* / adverse effects
Retrospective Studies
Stroke / epidemiology
Time Factors

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


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