Impact of Chronic Kidney Disease on the Presentation and Outcome of Patients Hospitalized With Atrial Fibrillation: Insights From Qatar

• Published in: Angiology 2018-03, Vol.69 (3), p.212-219
• Main Authors: Salim, Imtiaz, Al Suwaidi, Jassim, AlBinali, Hajar A, Singh, Rajvir, Al-Qahtani, Awad, Asaad, Nidal, Salam, Amar M.
• Format: Article
• Language: English
• Subjects: Aged; Anti-Arrhythmia Agents - therapeutic use; Anticoagulants - therapeutic use; Atrial Fibrillation - complications; Atrial Fibrillation - mortality; Atrial Fibrillation - therapy; Female; Hospital Mortality; Hospitalization; Humans; Male; Middle Aged; Odds Ratio; Qatar; Registries; Renal Insufficiency, Chronic - epidemiology; Retrospective Studies
• ISSN: 0003-3197; 1940-1574
• DOI: 10.1177/0003319717717849

Atrial fibrillation (AF) with coexistent chronic kidney disease (CKD) is poorly described in the literature. We compared the presenting symptoms, clinical characteristics, treatment, and outcome of patients hospitalized with AF with and without CKD in a large clinical registry. Data of patients hospitalized with AF between 1991 and 2012 in Qatar were analyzed. Of 5201 patients hospitalized for AF, 264 (5.1%) had CKD. Patients with AF and CKD were older with higher prevalence of other comorbidities and left ventricular dysfunction and were more likely to present with shortness of breath and chest pain compared with patients with AF alone who were more likely to present with palpitation. The crude in-hospital mortality was 3 times higher in patients with dual disease. On multivariable adjustments, CKD was an independent predictor of mortality (odds ratio: 2.84; 95% confidence interval: 1.33-6.08, P = .001). Further studies are warranted to try to reduce the increased mortality observed in this high-risk population.