Irregular Heart Beat Elevates Risk of Kidney Failure


SAN FRANCISCO—Many people who suffer from chronic kidney disease (CKD) progressively lose their kidney function over time and eventually develop a condition called end-stage renal disease (ESRD) — the complete failure of the kidneys—placing them in need of lifelong dialysis or a kidney transplant.

Now researchers at the University of California, San Francisco (UCSF) and the Kaiser Permanente Northern California Division of Research have found that the risk of kidney failure is greater for people with CKD who also have atrial fibrillation (A-fib), one of the most common forms of irregular heart rhythm in adults.

The finding opens the way for further studies into the relationship between the two factors, which could lead to new treatment approaches that would improve outcomes for people with CKD.

Doctors have known that patients with chronic kidney disease or end-stage renal disease commonly have A-fib and as a result are more likely to have a stroke or to die. However, the long-term impact of A-fib on kidney function among patients with known chronic kidney disease has been unknown.

The new study, published last month in the journal Circulation, involved 206,229 adults with CKD who were drawn from members of Kaiser Permanente Northern California, a large integrated health care delivery system. Over the course of about five years, approximately 16,400 patients developed A-fib, and those who did were 67 percent more likely to progress to end-stage renal disease compared with patients who had CKD but did not develop A-fib.

"These novel findings expand on previous knowledge by highlighting that atrial fibrillation is linked to a worse kidney prognosis in patients with underlying kidney dysfunction," said kidney specialist Nisha Bansal, MD, an assistant professor in the division of nephrology at UCSF.

"There is a knowledge gap about the long-term impact of atrial fibrillation on the risk of adverse kidney-related outcomes in patients with chronic kidney disease," said senior author Alan S. Go, MD, director of the Comprehensive Clinical Research Unit at the Kaiser Permanente Division of Research. "This study addresses that gap and may have important implications for clinical management by providing better prognostic information and leading to future work determining how to improve outcomes in this high-risk group of patients."

UCSF is one of the world's leading centers for kidney disease treatment, research and education. Its Division of Nephrology is ranked among the best programs in the nation by U.S. News & World Report.


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