Understanding the Link Between AFib and Kidney Disease
With contributions from Jeffrey R.
Is there a link between AFib and kidney problems? Yes, according to scientists. Exactly how these two conditions are related is not known, as the studies conducted so far have not found specific genes, pathways or biologic mechanisms that show a clear and understandable connection. However, the studies did reveal some fascinating facts:
- In the United States, more than 20 million people suffer from chronic kidney disease (CKD).
- A meta-analysis published in the May 2016 issue of New England Journal of Medicine established that having CKD corresponds to an increased risk of AFib.
- The rate of AFib for those individuals with CKD is two to three times greater than that seen in the general population.
- Prevalence of AFib in people with CKD is between seven and 18 percent depending on the type of measurement used in the study. The rate increases to 22-25 percent in people over the age of
- AFib occurs in 13 to 27 percent of individuals who undergo long-term dialysis.
It is known that both the prevalence of AFib and CKD is increasing, having risen twofold worldwide over the last ten years. Furthermore, AFib increases your chances of developing CKD.
If an individual has AFib, their likelihood of also having CKD is 10 to 15%. Also, the opposite is also true – patients with CKD are more likely to develop AFib compared with people considered part of the healthy population.
These two conditions are also linked with stroke: CKD predisposes a person with AFib to develop stroke, both hemorrhagic and ischemic, as well as other types of major bleeds. Both CKD and AFib elevate a person’s risk for the formation of blood clots.
- A 2013 study featured in the journal Circulation also found that the risk of kidney failure (the end stage of kidney disease) is more significant in those who have both CKD and AFib. This study evaluated over 200,000 participants with CKD for over five years. In this group, over 16,000 developed AFib, and those who died were 67 percent more likely to be diagnosed with kidney failure compared with those who had CKD without AFib.
- A study published in the Journal of the American Heart Association in 2012 demonstrated that more than 55,000 people with advanced stages of kidney disease experienced a 13 percent risk increase for developing AFib.
Risk Factor Management
People who have AFib paired with CKD have an increased risk for mortality compared with those who have only one of the conditions. If you have CKD, some of the factors that contribute to AFib occurring include:
- Advanced age
- Coronary artery disease
- A reduction in the heart’s ability to pump a normal amount of blood each contraction
- Heart failure
- High blood pressure
- History of a previous stroke or TIA
- Secondary hyperparathyroidism
One of the most problematic aspects of medical care if you have AFib and CKD is managing the risk of blood clot formation. CKD causes changes in physiologic function that result in changes to the normal flow of blood, which in turn increase the risk of clots and hemorrhaging.
Currently, there are no clear guidelines for managing this issue for people with AF and CKD. Researchers have yet to complete enough large randomized studies to assess the benefits of certain medications.
The Journal of the American Society of Nephrology published an article in 2008 that showed how individualized risk stratification could present the best method of treatment. The article goes on to provide an algorithm for blood thinner administration in patients with AFib and CKD using a type of evaluation tool called CHADS2 to determine ischemic stroke risk.
With any medical condition, it’s essential to work with your physician to control your risk factors. If you suffer from AFib, consider the tips on the next page for preventing CKD and its complications.