Morbidity and treatment in patients with atrial fibrillation and chronic kidney disease

Holger Reinecke, Michael Nabauer, Andrea Gerth, Tobias Limbourg, Andras Treszl, Christiane Engelbertz, Lars Eckardt, Paulus Kirchhof, Karl Wegscheider, Ursula Ravens, Thomas Meinertz, Gerhard Steinbeck, Günter Breithardt, AFNET Study Group

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19 Citations (Scopus)


Chronic kidney disease (CKD) is associated with increased cardiovascular morbidity and mortality but there are few studies available about atrial fibrillation, the most frequent arrhythmia in CKD, and the applied treatment. Based on the prospective German Competence NETwork on Atrial Fibrillation, data of 3138 patients with atrial fibrillation were analyzed and categorized by their estimated glomerular filtration rate (stages 1-3 and 4 plus 5). With advanced CKD, significantly more patients suffered from a more severe form of atrial fibrillation. Despite significantly higher CHADS2 scores in advanced CKD, oral anticoagulation was not prescribed more frequently while antiarrhythmic drugs and catheter ablations were used significantly less often, in contrast to more pacemaker implantations. However, in multivariate hierarchical logistic regression analyses of in-hospital treatments and complications, only hemorrhages and pacemaker implantations turned out to be independently and significantly associated with higher CKD stages. This nationwide study shows that patients with CKD and atrial fibrillation suffer from a markedly higher comorbidity. Thus, while CKD patients have received cardioversions, ablations, antiarrhythmic, or anticoagulation drugs significantly less often in their history, current treatments were not different if adjusted for multiple comorbidities. This might indicate an improvement in the often reported therapeutic nihilism in CKD.

Original languageEnglish
Pages (from-to)200-209
Number of pages10
JournalKidney International
Issue number1
Early online date4 Jun 2014
Publication statusPublished - Jan 2015


  • atrial fibrillation
  • chronic kidney disease
  • comorbidity
  • undertreatment


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