Impact of Renal Function on Mortality in Recently Hospitalized Patients with Atrial Fibrillation

In a study published in the Journal of Cardiovascular Medicine, researchers explored the impact of chronic kidney disease (CKD) and low estimated glomerular filtration rates (eGFR) on mortality outcomes in patients with atrial fibrillation. According to the study’s lead author, Evangelos Liampas, the presence of CKD was independently associated with decreased survival in a population of recently hospitalized patients with atrial fibrillation.

The findings were based on a post hoc analysis of 1,064 patients hospitalized with atrial fibrillation, of which 465 (43.7%) had CKD. Kaplan-Meier, multivariate Cox regression, and spline curves analyses were performed to assess associations between CKD stages 1-5 and various eGFR values and the primary outcome of all-cause death—as well as the secondary outcome of cardiovascular mortality.

Renal Function and Mortality Associations in Atrial Fibrillation

According to the article, the presence of CKD was associated with an increased risk for both all-cause mortality (adjusted hazard ratio [aHR], 1.60; 95% confidence interval [CI], 1.25-2.05) and cardiovascular mortality (aHR, 1.74; 95% CI, 1.30-2.33) after hospitalization for atrial fibrillation.

Additionally, compared to CKD stage 1, the aHRs for all-cause mortality of CKD stages 2 through 5 were 2.18, 2.62, 4,20, and 3.38, respectively (P<.05). In the authors’ spline curve analyses, eGFR values less than 50 ml/min/1.73 m² were independent predictions of higher all-cause and cardiovascular mortality in atrial fibrillation.

Overall, the authors judged that the presence of CKD was associated with decreased survival in recently hospitalized patients with atrial fibrillation, and that eGFR incrementally associated with poorer outcomes as values lowered.

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