title: Increased risk of atrial fibrillation in end-stage renal disease patients on dialysis: A nationwide, population-based study in Taiwan.
abstract: End-stage renal disease (ESRD) patients commonly have a higher risk of developing cardiovascular diseases than general population. Chronic kidney disease is an independent risk factor for atrial fibrillation (AF); however, little is known about the AF risk among ESRD patients with various modalities of renal replacement therapy. We used the Taiwan National Health Insurance Research Database to determine the incident AF among peritoneal dialysis (PD) and hemodialysis (HD) patients in Taiwan.Our ESRD cohort include Taiwan National Health Insurance Research Database, we identified 15,947 patients, who started renal replacement therapy between January 1, 2002 and December 31, 2003. From the same data source, 47,841 controls without ESRD (3 subjects for each patient) were identified randomly and frequency matched by gender, age (±1 year), and the year of the study patient's index date for ESRD between January 1, 2002 and December 31, 2003.During the follow-up period (mean duration: 8-10 years), 3428 individuals developed the new-onset AF. The incidence rate ratios for AF were 2.07 (95% confidence interval [CI] = 1.93-2.23) and 1.78 (95% CI = 1.30-2.44) in HD and PD groups, respectively. After we adjusted for age, gender, and comorbidities, the hazard ratios for the AF risk were 1.46 (95% CI = 1.32-1.61) and 1.32 (95% CI = 1.00-1.83) in HD and PD groups, respectively. ESRD patients with a history of certain comorbidities including hypertension, diabetes mellitus, hyperlipidemia, coronary artery disease, heart failure, valvular heart disease, and chronic obstructive pulmonary disease (COPD) have significantly increased risks of AF.This nationwide, population-based study suggests that incidence of AF is increased among dialysis ESRD patients. Furthermore, we have to pay more attention in clinical practice and long-term care for those ESRD patients with a history of certain comorbidities.
authors.affiliation: Department of Urology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi Department of Health and Nutrition Biotechnology, Asia University, Taichung Graduate Institute of Clinical Medicine, College of Medicine Division of Nephrology, Department of Internal Medicine, School of Medicine, Taipei Medical University, Taipei Department of Nephrology, Shuang Ho Hospital, Taipei Medical University, New Taipei City Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, Taipei Department of Urology, School of Medicine, Taipei Medical University, Taipei Department of Urology, Shuang Ho Hospital, Taipei Medical University Division of Nephrology, Department of Medicine, Cardinal-Tien Hospital, School of Medicine, Fu-Jen Catholic University Department of Medical Research, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
authors.forename: Cheng-Huang
authors.initials: CH
authors.lastname: Shen
authors.forename: Cai-Mei
authors.initials: CM
authors.lastname: Zheng
authors.forename: Kee-Thai
authors.initials: KT
authors.lastname: Kiu
authors.forename: Hsin-An
authors.initials: HA
authors.lastname: Chen
authors.forename: Chia-Chang
authors.initials: CC
authors.lastname: Wu
authors.forename: Kuo-Cheng
authors.initials: KC
authors.lastname: Lu
authors.forename: Yung-Ho
authors.initials: YH
authors.lastname: Hsu
authors.forename: Yuh-Feng
authors.initials: YF
authors.lastname: Lin
authors.forename: Yuan-Hung
authors.initials: YH
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D006435:Renal Dialysis / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult