Chronic Renal Insufficiency And Atrial Arrhythmias-A Correlation Research

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in the general population. AF prevalence in the general population ranges from 1% to 8%. Atrial fibrillation is one of the strongest risk factors for ischemic stroke and an independent predictor of death. Chronic Renal Insufficiency (CRI) is the most frequent clinical pathological condition, and often has disorders of cardiac structure and function, as well as internal environment imbalances. AF and CKD share several common risk factors (eg, hypertension, diabetes, preexisting cardiovascular disease, obesity, metabolic syndrome). Although a high prevalence of AF has been demonstrated in CRI in foreign studies, there are limited data on the prevalence and correlates of AF in CRI at domestic.Methods: Seven hundreds and fifty-four patients(63.3±16.4 years, 53.1% men) with CRI in the 2nd Hospital, Chongqing Medical University, Chongqing Zhongshan Hospital and Chongqing third people's hospital from 2006 January to 2009 June were included. Atrial fibrillation, atrial tachycardia (> one minute) and frequency atrial premature beats (>8000 beats/24h) documented by a 12-lead electrocardiogram, 24-h Holter and history were defined as atrial arrhythmia when all data were analyzed. Age-, sex-, and eGFR-specific prevalence rates of AF were estimated and compared between subgroups. Cross-sectional associations and correlates with prevalent AF and atrial arrhythmia were examined using binary logistic regression analysis.Result: The mean eGFR was 18.7±17.0 mL/(min 1.73 m~2); 89.4% of the study population had an eGFR≤45 mL/(min 1.73 m~2) and 45.6% were hemodialysis patients. Atrial fibrillation was present in 18.8% of the study population and in 25% of those≥70 years old, whereas atrial arrhythmia was present in 24.8%. Participants with eGFR≤45 mL/(min 1.73 m~2) had a higher prevalence of AF and atrial arrhythmia compared with participants with eGFR>45 mL/(min 1.73 m~2) (20.4% vs 16.0%, P = 0.001). By binary logistic regression analysis, age, history of CAD, DM, CHF and dialysis were significantly associated with AF and atrial arrhythmia. Sex, smoking, alcohol intake, BMI, hypertension, enlarged LAD and hyperlipemia were not significantly associated with AF. An eGFR≤45 mL/(min 1.73 m~2) might be also associated with AF , but it was not very significant (P = 0.117).Conclusions: Atrial fibrillation is much more frequent in CRI patients than in the general population; age, history of CAD, DM, CHF, and dialysis are associated with atrial arrhythmia.