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. 2023 Mar;38(3):402-411.
doi: 10.1007/s00380-022-02178-w. Epub 2022 Oct 17.

Characterization of baseline clinical factors associated with incident worsening kidney function in patients with non-valvular atrial fibrillation: the Hokuriku-Plus AF Registry

Kenshi Hayashi #  1 , Yoshihiro Tanaka #  2   3   4 , Toyonobu Tsuda  2 , Akihiro Nomura  2 , Noboru Fujino  2 , Hiroshi Furusho  2   5 , Norihiko Sakai  6 , Yasunori Iwata  6 , Soichiro Usui  2 , Kenji Sakata  2 , Takeshi Kato  2 , Hayato Tada  2 , Takashi Kusayama  2 , Keisuke Usuda  2 , Masa-Aki Kawashiri  2 , Rod S Passman  3   7 , Takashi Wada  6 , Masakazu Yamagishi  2   8 , Masayuki Takamura  2 ; Hokuriku-Plus AF Registry Investigators
Collaborators, Affiliations

Characterization of baseline clinical factors associated with incident worsening kidney function in patients with non-valvular atrial fibrillation: the Hokuriku-Plus AF Registry

Kenshi Hayashi et al. Heart Vessels. 2023 Mar.

Erratum in

Abstract

Evidence suggests that atrial fibrillation (AF) could increase the risk of worsening kidney function (WKF) which is linked to an increased risk of stroke, bleeding, and death in AF patients. However, limited data exist regarding the factors that could lead to WKF in these patients. Therefore, we sought to identify the potential factors associated with the development of WKF in patients with non-valvular AF (NVAF). We analyzed prospectively recruited 1122 NVAF patients [men 71.9%, median age 73.0 years (interquartile range: 66.0-79.0)] with a baseline estimated glomerular filtration rate (eGFR) ≥ 15 mL/min/1.73 m2 from the Hokuriku-Plus AF Registry. The primary outcome was incident WKF, defined as the %eGFR change from the baseline ≥ 30% during the follow-up period. We evaluated the association between baseline variables and incident WKF using univariate and multivariate Cox proportional hazard models. We also evaluated the non-linear association between the identified factors and incident WKF. During a median follow-up period of 3.0 years (interquartile range: 2.7-3.3), incident WKF was observed in 108 patients (32.6 per 1000 person-years). Compared to the patients without incident WKF, the patients with incident WKF were older and had a higher prevalence of heart failure (HF), diabetes mellitus (DM), and vascular disease at baseline. Those who experienced incident WKF also had higher diastolic blood pressure, lower hemoglobin, lower eGFR, higher B-type natriuretic peptide (BNP) and used warfarin more frequently. Upon multivariate analysis, age ≥ 75 years, HF, DM, and anemia were independently associated with incident WKF. Additionally, age and hemoglobin were linearly associated with the risk of incident WKF, whereas a J- or U-shaped association was observed for HbA1c and BNP. Age ≥ 75 years, HF, DM, and anemia were associated with the development of WKF in Japanese patients with NVAF. In patients with these risk factors, a careful monitoring of the kidney function and appropriate interventions may be important when possible.

Keywords: Atrial fibrillation; End-stage kidney disease; Worsening kidney function; eGFR.

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References

    1. Wolf PA, Abbott RD, Kannel WB (1991) Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 22:983–988
    1. Hayashi K, Tsuda T, Nomura A, Fujino N, Nohara A, Sakata K, Konno T, Nakanishi C, Tada H, Nagata Y, Teramoto R, Tanaka Y, Kawashiri MA, Yamagishi M, Hokuriku-Plus AFRI (2018) Impact of B-type natriuretic peptide level on risk stratification of thromboembolism and death in patients with nonvalvular atrial fibrillation-the Hokuriku-plus AF registry. Circ J 82:1271–1278
    1. Tanaka Y, Shah NS, Passman R, Greenland P, Lloyd-Jones DM, Khan SS (2021) Trends in cardiovascular mortality related to atrial fibrillation in the United States, 2011 to 2018. J Am Heart Assoc 10:e020163
    1. Usuda K, Kato T, Tsuda T, Tada H, Niwa S, Usui S, Sakata K, Hayashi K, Furusho H, Kawashiri M, Takamura M, Otsuka T, Suzuki S, Hirata A, Murakami M, Takami M, Kimura M, Fukaya H, Nakahara S, Shimizu W, Iwasaki YK, Hayashi H, Harada T, Nakajima I, Okumura K, Koyama J, Tokuda M, Yamane T, Momiyama Y, Tanimoto K, Soejima K, Nonoguchi N, Ejima K, Hagiwara N, Harada M, Sonoda K, Inoue M, Kumagai K, Hayashi H, Satomi K, Yazaki Y, Watari Y, Arai M, Watanabe R, Yokoyama K, Matsumoto N, Nagashima K, Okumura Y, on behalf of the AFAFR (2022) Impact of sinus rhythm maintenance on major adverse cardiac and cerebrovascular events after catheter ablation of atrial fibrillation: insights from AF frontier ablation registry. Heart Vessels 37:327–336
    1. Watanabe H, Watanabe T, Sasaki S, Nagai K, Roden DM, Aizawa Y (2009) Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am Heart J 158:629–636

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