Atrial fibrillation in chronic dialysis patients in the United states: risk factors for hospitalization and mortality

BMC Nephrology

Lawrence Y Agodoa¹  Allen J Taylor⁴  Fernando C Trespalacios²  Kevin C Abbott³ 

[1]NIDDK, NIH, Bethesda, MD, USA

[2]Nephrology Service, Madigan Army Medical Center, Ft. Lewis, WA, USA

[3]Nephrology Service, Walter Reed Army Medical Center, Washington, D.C., and Uniformed Services University of the Health Sciences, Bethesda, MD, USA

[4]Cardiology Service, Walter Reed Army Medical Center, Washington, D.C, USA

关键词: blood pressure;    age;    USRDS;    beta-blockers;    coumadin;    dialysis;    hospitalization;    atrial fibrillation;   

Others  :  1083456
DOI  :  10.1186/1471-2369-4-1

 received in 2002-10-23, accepted in 2003-01-24,  发布年份 2003

【 摘 要 】

Background

The incidence and risk factors for hospitalized atrial fibrillation have not been previously assessed in a national population of dialysis patients.

Methods

We analyzed the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study (DMMS) Wave II in a historical cohort study of hospitalized atrial fibrillation. Data from 3374 patients who started dialysis in 1996 with valid follow-up times were available for analysis, censored at the time of renal transplantation and followed until November 2000. Cox Regression analysis was used to model factors associated with time to first hospitalization for atrial fibrillation (ICD9 code 427.31x) adjusted for comorbidities, demographic factors, baseline laboratory values, blood pressures, dialysis modality, and cardioprotective medications.

Results

The incidence density of atrial fibrillation was 12.5/1000 person years. Factors associated with atrial fibrillation were older age (> = 71 years vs. <48 years), extremes (both high and low) of pre-dialysis systolic blood pressure, dialysis modality (hemodialysis vs. peritoneal dialysis), and digoxin use. Baseline use of coumadin was associated with reduced mortality in patients later hospitalized for atrial fibrillation.

Conclusions

Dialysis patients had a high incidence of atrial fibrillation. This risk was largely segregated among those with established risk factors for atrial fibrillation, and hemodialysis patients. Use of coumadin was associated with improved survival among patients later hospitalized for atrial fibrillation.

【 授权许可】

   
2003 Abbott et al; licensee BioMed Central Ltd. This is an Open Access article: verbatim copying and redistribution of this article are permitted in all media for any purpose, provided this notice is preserved along with the article's original URL.

【 图 表 】

Figure 1.

Figure 2.

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