Prognostic differences between pre-existing atrial fibrillation in chronic kidney disease and new-onset atrial fibrillation at hemodialysis initiation

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https://storage.unitedwebnetwork.com/files/1099/61e3a4a7e627a0b75aadfe6e50bc8a21.pdf

Abstract Title *

Prognostic differences between pre-existing atrial fibrillation in chronic kidney disease and new-onset atrial fibrillation at hemodialysis initiation

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Co-author 1

Tomohisa Tsuyuki t.tomohishai002@gmail.com Nagasaki University Hospital Nephrology Nagasaki Japan *

Co-author 2

Mineaki Kitamura minekitamura@nagasaki-u.ac.jp Nagasaki University Hospital Nephrology Nagasaki Japan -

Co-author 3

Haruka Fukuda haruka.hys884@gmail.com Nagasaki Harbor Medical Center Nephrology Nagasaki Japan -

Co-author 4

Takuma Ishii sp5d93a9@yahoo.co.jp Nagasaki Harbor Medical Center Nephrology Nagasaki Japan -

Co-author 5

Kenta Torigoe ktorigoe@nagasaki-u.ac.jp Nagasaki University Hospital Nephrology Nagasaki Japan -

Co-author 6

Hiroshi Yamashita yamashita@mtf.biglobe.ne.jp Nagasaki Harbor Medical Center Nephrology Nagasaki Japan -

Co-author 7

Tomoya Nishino tnishino@nagasaki-u.ac.jp Nagasaki University Hospital Nephrology Nagasaki Japan -

Co-author 8

Co-author 9

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

Atrial fibrillation (AF) can develop in patients with chronic kidney disease. However, the impact of new-onset AF in patients initiating hemodialysis remains unclear.

Methods

We categorized 254 patients who began hemodialysis into three groups: those with pre-existing AF, those with new-onset AF, and those without AF. Statistical analyses were performed to evaluate the associations between patient characteristics and survival outcomes.

Results

AF was observed in 42 patients (16.5%), of whom 19 (7.5%) had pre-existing AF and 23 (9.1%) developed new-onset AF at the initiation of hemodialysis. Multivariate logistic regression models showed that only low serum albumin levels were associated with AF (P = 0.04). Age- and other factors-adjusted multivariable Cox regression models indicated that AF, particularly pre-existing AF, was an independent risk factor for death after dialysis initiation (hazard ratio [HR]: 2.28, 95% confidence interval [CI]: 1.39–3.74, P = 0.001; HR: 3.05, 95% CI: 1.64–5.66, P = 0.004, respectively). However, new-onset AF was not significantly associated with mortality (HR: 1.43, 95% CI: 0.74–2.78, P = 0.28).

Conclusion

These findings suggest that pre-existing AF before hemodialysis initiation has a crucial impact on patient prognosis.

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