Abstract 1571: Association of Chronic Kidney Disease With Atrial Fibrillation in the United States
Atrial fibrillation (AF) is common among patients with end-stage renal disease, but little is known about its prevalence among adults with chronic kidney disease (CKD) of lesser severity. We studied the association of CKD with electrocardiogram-confirmed AF among 26,917 participants in the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a population-based cohort of African-American and white US adults ≥45 years of age. During an in-home study visit, blood and urine samples were collected and electrocardiograms were conducted by trained staff. Estimated glomerular filtration rate (eGFR) was calculated using the abbreviated Modification of Diet in Renal Disease study equation and microalbuminuria was defined as a urinary albumin to creatinine ratio ≥30 mg/g. Patients were categorized by renal function: no CKD (eGFR ≥60 ml/min/1.73m2 without microalbuminuria; n=21,081), stage 1–2 CKD (eGFR ≥60 ml/min/1.73m2 with microalbuminuria; n=2,938), stage 3 CKD (eGFR 30 to 59 ml/min/1.73m2; n=2,683) and stage 4 –5 CKD (eGFR <30 ml/min/1.73m2; n=215). The prevalence of AF in each category was 1.0, 2.8, 2.7 and 4.2%, respectively. Compared to participants without CKD, the age, race, sex adjusted odds ratios for prevalent AF were 2.67 (95% CI 2.04 –3.48), 1.68 (95% CI 1.26 –2.24) and 3.52 (95% CI 1.73–7.15) among those with stage 1–2, stage 3 and stage 4 –5 CKD, respectively (Table⇓). The association between CKD and prevalent AF was attenuated but remained statistically significant after further multivariable adjustment. This association also remained consistent across subgroups, including African-Americans and whites. In conclusion, CKD is associated with an increased prevalence of AF in this population-based cohort of US adults.