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Clinical Epidemiology
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The Increasing Prevalence of Atrial Fibrillation among Hemodialysis Patients

Wolfgang C. Winkelmayer, Amanda R. Patrick, Jun Liu, M. Alan Brookhart and Soko Setoguchi
JASN February 2011, 22 (2) 349-357; DOI: https://doi.org/10.1681/ASN.2010050459
Wolfgang C. Winkelmayer
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Amanda R. Patrick
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Jun Liu
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M. Alan Brookhart
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Soko Setoguchi
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Abstract

A half million Americans have ESRD, which puts them at high risk for cardiovascular disease and poor outcomes. Little is known about the epidemiology of atrial fibrillation among patients with ESRD. We analyzed data from annual cohorts (1992 to 2006) of prevalent hemodialysis patients from the United States Renal Data System. In each cohort, we searched 1 year of medical claims for relevant diagnosis codes to determine the prevalence of atrial fibrillation. Among 2.5 million patient observations, 7.7% had atrial fibrillation, with the prevalence increasing 3-fold from 3.5% (1992) to 10.7% (2006). The number of affected patients increased from 3620 to 23,893 (6.6-fold) during this period. Older age, male gender, and several comorbid conditions were associated with increased risk for atrial fibrillation. Compared with otherwise similar Caucasians, the prevalence of atrial fibrillation rates was substantially lower for blacks, Asians, and Native Americans. One-year mortality was twice as high among hemodialysis patients with atrial fibrillation compared with those without (39% versus 19%), and this increased risk was constant during the 15 years of the study. In conclusion, the prevalence of diagnosed atrial fibrillation among patients receiving hemodialysis in the United States is increasing, varies by race, and remains associated with substantially increased mortality. Identifying potentially modifiable risk factors for incident atrial fibrillation requires further investigation.

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  • Copyright © 2011 by the American Society of Nephrology
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Journal of the American Society of Nephrology: 22 (2)
Journal of the American Society of Nephrology
Vol. 22, Issue 2
1 Feb 2011
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The Increasing Prevalence of Atrial Fibrillation among Hemodialysis Patients
Wolfgang C. Winkelmayer, Amanda R. Patrick, Jun Liu, M. Alan Brookhart, Soko Setoguchi
JASN Feb 2011, 22 (2) 349-357; DOI: 10.1681/ASN.2010050459

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The Increasing Prevalence of Atrial Fibrillation among Hemodialysis Patients
Wolfgang C. Winkelmayer, Amanda R. Patrick, Jun Liu, M. Alan Brookhart, Soko Setoguchi
JASN Feb 2011, 22 (2) 349-357; DOI: 10.1681/ASN.2010050459
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More in this TOC Section

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  • Association of Clonal Hematopoiesis of Indeterminate Potential with Worse Kidney Function and Anemia in Two Cohorts of Patients with Advanced Chronic Kidney Disease
  • Longitudinal TNFR1 and TNFR2 and Kidney Outcomes: Results from AASK and VA NEPHRON-D
Show more Clinical Epidemiology

Cited By...

  • Racial/Ethnic Disparities in Atrial Fibrillation Treatment and Outcomes among Dialysis Patients in the United States
  • Oral Anticoagulation for Patients With Atrial Fibrillation on Long-Term Dialysis
  • Cardiovascular Events after New-Onset Atrial Fibrillation in Adults with CKD: Results from the Chronic Renal Insufficiency Cohort (CRIC) Study
  • The Impact of Atrial Fibrillation Clinical Subtype on Mortality
  • eGFR and Albuminuria in Relation to Risk of Incident Atrial Fibrillation: A Meta-Analysis of the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study
  • Apixaban Pharmacokinetics at Steady State in Hemodialysis Patients
  • Warfarin utilisation and anticoagulation control in patients with atrial fibrillation and chronic kidney disease
  • National Trends and Impact of Acute Kidney Injury Requiring Hemodialysis in Hospitalizations With Atrial Fibrillation
  • Asymptomatic Intradialytic Supraventricular Arrhythmias and Adverse Outcomes in Patients on Hemodialysis
  • Use of Oral Anticoagulation in the Management of Atrial Fibrillation in Patients with ESRD: Pro
  • Pragmatic Trials in Maintenance Dialysis: Perspectives from the Kidney Health Initiative
  • Efficacy and safety of warfarin in dialysis patients with atrial fibrillation: a systematic review and meta-analysis
  • Arrhythmia and Sudden Death in Hemodialysis Patients: Protocol and Baseline Characteristics of the Monitoring in Dialysis Study
  • Epidemiology and Mechanisms of Uremia-Related Cardiovascular Disease
  • Risks of Death and Stroke in Patients Undergoing Hemodialysis With New-Onset Atrial Fibrillation: A Competing-Risk Analysis of a Nationwide Cohort
  • Incident Atrial Fibrillation and Risk of Death in Adults With Chronic Kidney Disease
  • Incident Atrial Fibrillation Among Asians, Hispanics, Blacks, and Whites
  • Evidence-Based Cardiology in Hemodialysis Patients
  • Preventing Stroke in Patients With Chronic Kidney Disease and Atrial Fibrillation: Benefit and Risks of Old and New Oral Anticoagulants
  • More Evidence on an Abominable Pairing: Atrial Fibrillation and Kidney Disease
  • Incident Atrial Fibrillation and Risk of End-Stage Renal Disease in Adults With Chronic Kidney Disease
  • Trends in the Incidence of Atrial Fibrillation in Older Patients Initiating Dialysis in the United States
  • Impact of Chronic Kidney Disease on Risk of Incident Atrial Fibrillation and Subsequent Survival in Medicare Patients
  • Trends in Acute Nonvariceal Upper Gastrointestinal Bleeding in Dialysis Patients
  • Effectiveness and Safety of Warfarin Initiation in Older Hemodialysis Patients with Incident Atrial Fibrillation
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