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Association of Chronic Kidney Disease with Atrial Fibrillation Among Adults in the United States: Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.
Circ Arrhythm Electrophysiol. 2010 Nov 13;
Authors: Baber U, Howard VJ, Halperin JL, Soliman EZ, Zhang X, McClellan W, Warnock DG, Muntner P
BACKGROUND: -Atrial fibrillation (AF) is common among patients with end-stage renal disease, but few data are available on its prevalence among adults with chronic kidney disease (CKD) of lesser severity. METHODS AND RESULTS: -We evaluated the association of CKD with electrocardiogram-detected AF among 26,917 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a population-based cohort of African-American and white US adults ? 45 years of age. Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease study equation and albuminuria was defined as a urinary albumin to creatinine ratio ?30 mg/g. Participants were categorized by renal function: no CKD (eGFR ?60 ml/min/1.73m(2) without albuminuria, n=21,081), stage 1-2 CKD (eGFR ?60 ml/min/1.73m(2) with albuminuria n=2,938), stage 3 CKD (eGFR 30 to 59 ml/min/1.73m(2), n=2,683) and stage 4-5 CKD (eGFR <30 ml/min/1.73m(2), n=215). The prevalence of AF among participants without CKD, and with stage 1-2, stage 3, and stage 4-5 CKD was 1.0%, 2.8%, 2.7% and 4.2%, respectively. Compared to participants without CKD, the age, race, sex adjusted odds ratios for prevalent AF were 2.67 (95% CI 2.04 - 3.48), 1.68 (95% CI 1.26 - 2.24) and 3.52 (95% CI 1.73 - 7.15) among those with stage 1-2, stage 3 and stage 4-5 CKD. The association between CKD and prevalent AF remained statistically significant after further multivariable adjustment and was consistent across numerous subgroups. CONCLUSIONS: -Regardless of severity, CKD is associated with an increased prevalence of AF among US adults.
PMID: 21076159 [PubMed - as supplied by publisher]