Long-term outcomes of dialysis in patients with chronic kidney disease and new-onset atrial fibrillation: A population-based cohort study
Autoři:
Tung-Wei Hung aff001; Jing-Yang Huang aff002; Gwo-Ping Jong aff003
Působiště autorů:
Division of Nephrology, Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung, Taiwan, ROC
aff001; Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan, ROC
aff002; Division of Cardiology, Department of Internal Medicine, Chung Shan Medical University Hospital and Chung Shan Medical University, Taichung, Taiwan, ROC
aff003
Vyšlo v časopise:
PLoS ONE 14(9)
Kategorie:
Research Article
prolekare.web.journal.doi_sk:
https://doi.org/10.1371/journal.pone.0222656
Souhrn
Background
Chronic kidney disease (CKD) is associated with substantial cardiovascular morbidity. Atrial fibrillation (AF) is a prevalent arrhythmia that increases the risk of both stroke and cardiovascular mortality. Information about the mortality risk among patients with advanced CKD and new-onset AF (NAF) in the presence and absence of dialysis is important. However, the association between advanced CKD and NAF in patients with and without dialysis is unclear.
Objective
To investigate long-term outcomes of the association between advanced CKD and NAF in patients with and without dialysis.
Methods
We conducted a nested case-control study based on the National Health Insurance Program in Taiwan. Each participant aged 20 years and older who had CKD with dialysis from 2000 to 2013 was assigned to the dialysis group, whereas sex-, age-, CKD duration-, and index date-matched participants without dialysis were randomly selected and assigned to the non-dialysis group. We used the Cox regression model to estimate the hazard ratio (HR) with the 95% confidence interval (CI) for mortality in CKD patients with combined dialysis and NAF. Patients with neither NAF nor dialysis served as the reference group.
Results
We identified 3,673 dialysis cases and 7,346 Non-dialysis matched controls for enrolment in the study. The crude mortality rates were 3.3 (95% CI: 3.1–3.5), 10.98 (95% CI: 9.3–13.0), 9.2 (95% CI: 8.7–10.0), and 18.0 (95% CI: 15.4–21.2) in the [Non-dialysis, non-NAF], [Non-dialysis, NAF], [Dialysis, non-NAF], and [Dialysis, NAF] groups, respectively. After adjustment for age, gender, and co-morbidities, the aHRs were 2.0 (95% CI: 1.7–2.3), 2.7 (95% CI: 2.5–2.9), and 3.5 (95% CI: 2.9–4.1) in the [Non-Dialysis, NAF], [Dialysis, non-NAF], and [Dialysis, NAF] groups compared with the [Non-Dialysis, non-NAF] group, respectively. The Kaplan-Meier survival curves showed the highest mortality risk in the [Dialysis, NAF] group among the study groups. Patients with concurrent peritoneal dialysis and AF had the highest mortality risk: aHR = 4.3 (95% CI: 2.3–8.0). However, there was a relatively lower effect of NAF on mortality in patients on dialysis than in patients who were not.
Conclusions
Patients with advanced CKD and NAF had a significantly increased risk of mortality. Dialysis is not risky for patients with concurrent CKD and NAF. Dialysis offers a sufficient survival benefit to be considered as a standard treatment, as indicated by the superior physical status of patients on dialysis.
Klíčová slova:
stroke – Biology and life sciences – Population biology – Medicine and health sciences – Population metrics – Death rates – Endocrinology – Endocrine disorders – Metabolic disorders – Pulmonology – Neurology – Cerebrovascular diseases – Ischemic stroke – Vascular medicine – Cardiology – Chronic obstructive pulmonary disease – Coronary heart disease – Nephrology – Chronic kidney disease – Medical dialysis – Arrhythmia – Atrial fibrillation
Zdroje
1. Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006; 114(2): 119–125. doi: 10.1161/CIRCULATIONAHA.105.595140 16818816.
2. Rahman F, Kwan GF, Benjamin EJ. Global epidemiology of atrial fibrillation. Nat Rev Cardiol. 2014; 11(11): 639–654. https://doi.org/10.1038/nrcardio.2016.114. 25113750.
3. Chou CY, Kuo HL, Wang SM, Liu JH, Lin HH, Liu YL, et al. Outcome of atrial fibrillation among patients with end-stage renal disease. Nephrol Dial Transplant. 2010; 25(4): 1225–1230. https://doi.org/10.1093/ndt/gfp589. 19923144
4. Kulkarni N, Gukathasan N, Sartori S, Baber U. Chronic kidney diseases and atrial fibrillation: A contemporary overview. J Atrial Fib. 2012; 5(1): 62–70. http://jafib.com/published.php?type=pdf&id=448.
5. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014; 129(8): 837–847. https://doi.org/10.1161/CIRCULATIONAHA.113.005119. 24345399.
6. Bansal N, Fan D, Hsu CY, Ordonez JD, Marcus GM, Go AS. Incident atrial fibrillation and risk of end-stage renal disease in adults with chronic kidney disease. Circulation. 2013; 127(5): 569–574. https://doi.org/10.1161/CIRCULATIONAHA.112.123992. 23275377.
7. Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998; 98(10): 946–952. doi: 10.1161/01.cir.98.10.946 9737513.
8. Das M, Aronow WS, McClung JA, Belkin RN. Increased prevalence of coronary artery disease, silent myocardial ischemia, complex ventricular arrhythmias, atrial fibrillation, left ventricular hypertrophy, mitral annular calcium, and aortic valve calcium in patients with chronic renal insufficiency. Cardiol Rev. 2006; 14(1): 14–17. 16371761.
9. Vazquez-Ruiz de Castroviejoa E, Sanchez-Perales C, Lozano-Cabezas C, García-Cortés MJ, Guzmán-Herrera M, Borrego-Utiel F, et al. Incidence of atrial fibrillation in hemodialysis patients. A prospective long-term follow-up study. Rev Esp Cardiol. 2006; 59(8): 779–784. 16938226.
10. Krane V, Heinrich F, Meesmann M, Olschewski M, Lilienthal J, Angermann C, et al. Electrocardiography and outcome in patients with diabetes mellitus on maintenance hemodialysis. Clin J Am Soc Nephrol. 2009;4(2):394–400. https://doi.org/10.2215/CJN.02020408. 19158371.
11. Konigsbrugge O, Posch F, Antlanger M, Kovarik J, Klauser-Braun R, Kletzmayr J, et al. Prevalence of Atrial Fibrillation and Antithrombotic Therapy in Hemodialysis Patients: Cross-Sectional Results of the Vienna InVestigation of AtriaL Fibrillation and Thromboembolism in Patients on HemoDIalysis (VIVALDI). PLoS One. 2017; 12(1): e0169400. https://doi.org/10.1371/journal.pone.0169400. 28052124.
12. Liao JN, Chao TF, Liu CJ, Wang KL, Chen SJ, Lin YJ, et al. Incidence and risk factors for new-onset atrial fibrillation among patients with end-stage renal disease undergoing renal replacement therapy. Kidney Int. 2015; 87(6): 1209–1215. https://doi.org/10.1038/ki.2014.393. 25587708.
13. Abbott KC, Trespalacios FC, Taylor AJ, Agodoa LY. Atrial fibrillation in chronic dialysis patients in the United States: risk factors for hospitalization and mortality. BMC Nephrol 2003;4:1. doi: 10.1186/1471-2369-4-1 12546711.
14. Shen CH, Zheng CM, Kiu KT, Chen HA, Wu CC, Lu KC, et al. Increased risk of atrial fibrillation in end-stage renal disease patients on dialysis: A nationwide, population-based study in Taiwan. Medicine (Baltimore). 2016; 95(25): e3933. https://doi.org/10.1097/MD.0000000000003933. 27336884.
15. Winkelmayer WC, Patrick AR, Liu J, Brookhart MA, Setoguchi S. The increasing prevalence of atrial fibrillation among hemodialysis patients. J Am Soc Nephrol. 2011; 22(2): 349–357. https://doi.org/10.1681/ASN.2010050459. 21233416.
16. Findlay MD, Thomson PC, Fulton RL, Solbu MD, Jardine AG, Patel RK,et al. Risk Factors of Ischemic Stroke and Subsequent Outcome in Patients Receiving Hemodialysis. Stroke. 2015; 46(9): 2477–2481. https://doi.org/10.1161/STROKEAHA.115.009095. 26230856.
17. Baber U, Howard VJ, Halperin JL, Soliman EZ, Zhang X, McClellan W, et al. 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. 2011; 4(1): 26–32. https://doi.org/10.1161/CIRCEP.110.957100. 21076159.
18. Zebe H. Atrial fibrillation in dialysis patients. Nephrol Dial Transplant. 2000; 15(6): 765–768. doi: 10.1093/ndt/15.6.765 10831625.
19. Wizemann V, Tong L, Satayathum S, Disney A, Akiba T, Fissell RB, et al. Atrial fibrillation in hemodialysis patients: clinical features and associations with anticoagulant therapy. Kidney Int. 2010; 77(12): 1098–1106. https://doi.org/10.1038/ki.2009.477. 20054291.
20. Soliman EZ, Prineas RJ, Go AS, Xie D, Lash JP, Rahman M, et al. Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort (CRIC). Am Heart J. 2010; 159(6): 1102–1107. https://doi.org/10.1016/j.ahj.2010.03.027. 20569726.
21. Atar I, Konas D, Acikel S, Külah E, Atar A, Bozbaş H, et al. Frequency of atrial fibrillation and factors related to its development in dialysis patients. Int J Cardiol. 2006; 106(1): 47–51. https://doi.org/10.1016/j.ijcard.2004.12.048. 16321665.
22. Abuhasira R, Mizrakli Y, Shimony A, Novack V, Shnaider A, Haviv YS. Atrial Fibrillation Characteristics in Patients on Haemodialysis vs. Peritoneal Dialysis. Sci Rep. 2018; 8(1): 2976. https://doi.org/10.1038/s41598-018-21229-9. 29445225.
Článok vyšiel v časopise
PLOS One
2019 Číslo 9
- Metamizol jako analgetikum první volby: kdy, pro koho, jak a proč?
- Nejasný stín na plicích – kazuistika
- Masturbační chování žen v ČR − dotazníková studie
- Těžké menstruační krvácení může značit poruchu krevní srážlivosti. Jaký management vyšetření a léčby je v takovém případě vhodný?
- Fixní kombinace paracetamol/kodein nabízí synergické analgetické účinky
Najčítanejšie v tomto čísle
- Graviola (Annona muricata) attenuates behavioural alterations and testicular oxidative stress induced by streptozotocin in diabetic rats
- CH(II), a cerebroprotein hydrolysate, exhibits potential neuro-protective effect on Alzheimer’s disease
- Comparison between Aptima Assays (Hologic) and the Allplex STI Essential Assay (Seegene) for the diagnosis of Sexually transmitted infections
- Assessment of glucose-6-phosphate dehydrogenase activity using CareStart G6PD rapid diagnostic test and associated genetic variants in Plasmodium vivax malaria endemic setting in Mauritania