Clinical and pathogenetic associations in atrial fibrillation with concomitant chronic kidney disease


G.G. Kijakbaev, V.V. Fomin, T.N. Krasnova

Aim: Identify the clinical and pathogenetic associations in patients with atrial fibrillation and chronic kidney disease stages II–IV.
Materials and methods: The study included 46 patients (21 men and 25 women) with atrial fibrillation (AF) and chronic kidney disease (CKD) II–IIV stages, aged 52 to 84 years, mean age 69±9 years. To carry out the main analysis, all patients were divided into 2 groups first according to CKD stages, then depending on AF type.
Results: Patients with CKD stage III-IV had significantly higher levels of creatinine and uric acid than patients with CKD stage II. The level of NT-proBNP, as an indicator of myocardial injury, was also higher in the CKD stage III-IV. All patients with a history of ischemic stroke had CKD stage III-IV. The second group patients more often received anticoagulation therapy and had a higher stratification risk of thrombotic complications of AF. Patients with CKD stages III-IV had significantly larger LA, moreover, all the patients in this group had left ventricular diastolic dysfunction. Patients with persistent AF had significantly higher levels of creatinine, uric acid and potassium compared with patients with paroxysmal AF. The level of NT-proBNP was also higher in patients with persistent AF. The size of the LA was significantly larger in patients with persistent AF.
Conclusion: Hemodynamic and metabolic alterations associated with a reduction in glomerular filtration rate, play an important role in the development and maintenance of AF, and increase the risk of thrombotic complications.

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