Incidence rate of atrial fibrillation after dialysis initiation and its relationship with cardiovascular events

Abstract

Aim: This study aimed to investigate the incidence of atrial fibrillation (AF) and its prognosis in the patients after dialysis initiation.Methods: A total of 1524 patients with chronic kidney disease who were initiated on dialysis were included. Dialysis was initiated between October 2011 and September 2013. Electrocardiogram was obtained at dialysis initiation, in March 2015, and September 2016. The mortality and cardiovascular disease (CVD) event rates of 1520 patients (1028 men and 492 women; mean age, 67.5 ± 13.1 years) who were followed up were compared, and they were divided into 2 groups: the AF group (with AF at least once) and N group (without AF).Results: The prevalence of AF was 6.2, 7.9, and 6.5% at dialysis initiation, in March 2015, and September 2016, respectively, and the incidence of new AF onset was 4.8% in March 2015 and 2.3% in September 2016. In total, 45 (28.0%) and 347 (25.5%) patients died in the AF and N groups, (p = .508), respectively. The incidence rates of CVD event were 91 (56.5%) and 413 (30.4%) in the AF and N groups (p < .001), respectively. In the multivariate analysis, mortality was not significant, but the incidence of CVD event was significantly higher in the AF group. Albumin level was associated with new-onset AF.Conclusions: After dialysis initiation, a high incidence of new-onset AF was observed. The lower albumin value at the time of dialysis initiation is more likely to be associated with AF development. Attention should be paid to the CVD events in the AF group.

Keywords: Dialysis; atrial fibrillation; cardiovascular events; chronic kidney disease; mortality.