Is there an increased risk of atrial fibrillation and stroke in CKD?
The risk of atrial fibrillation increases with the decline in the GFR. By the time patients have progressed to ESKD and are requiring dialysis, the prevalence of atrial fibrillation is at least 10-fold higher than in the general population, so around 1 in 8 dialysis patients suffer from atrial fibrillation.
Previous and ongoing studies with arrhythmia-monitoring devices suggest that atrial fibrillation may be even more common and underdiagnosed in the dialysis population.
It is thought that coronary artery disease, degenerative valvular disease, left ventricular hypertrophy, and fluctuating levels of electrolytes during hemodialysis likely promote the arrhythmia.
Atrial fibrillation carries an increased risk of thromboembolic stroke in CKD patients.
The US Renal Data System reported an annual incidence of 15% in hemodialysis patients compared with 10% in patients with CKD not undergoing dialysis, and 3% in individuals without CKD.
The 2-year mortality rates after stroke in these subgroups were 74%, 55%, and 28%, respectively.
