Pre-transplant, atrial fibrillation more likely in patients on hemodialysis
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Key takeaways:
- Atrial fibrillation was 20% more likely in patients who had hemodialysis vs. peritoneal dialysis.
- In the retrospective study, atrial fibrillation occurred in 286 adults who received peritoneal dialysis.
Patients who receive hemodialysis prior to their first kidney transplant may be more likely to develop atrial fibrillation compared with patients who have peritoneal dialysis, according to recent data.
“Individuals with kidney failure receiving dialysis are at particularly high risk of [atrial fibrillation] AF, where as many as one in three patients receiving hemodialysis had an episode of AF during 6 months of rhythm monitoring using loop recorder devices,” Leonardo Pozo Garcia, MD, from the section of nephrology in the department of medicine at Baylor College of Medicine in Houston, wrote with colleagues. “We conducted this study to determine whether pre-transplant dialysis modality, specifically hemodialysis [vs.] peritoneal dialysis, was associated with risk of post-transplant AF.”
Researchers used information from the United States Renal Data System to examine 43,621 adult Medicare-insured patients who received their first kidney transplant between 2005 and 2012, and who had not previously been diagnosed with AF. The primary exposure for the retrospective analysis was dialysis modality prior to transplant, while the main outcome was time to incidence of AF within 3 years post-transplant.
Overall, 84.9% of the patients received hemodialysis and 15.1% had peritoneal dialysis before transplantation.
According to results, AF occurred in 286 patients who received peritoneal dialysis during 15,363 person-years and 2,315 patients who received hemodialysis during 83,536 person-years prior to kidney transplant. The number of person-years refers to the overall number of years people participate in a study.
After adjusting for multiple variables, researchers found AF was 20% more likely in those who had hemodialysis vs. peritoneal dialysis. Additionally, each year of pre-transplant dialysis vintage increased the risk of post-transplant AF by 6%.
Investigators also highlighted other factors associated with developing post-transplant AF, such as a previous solid organ transplant, female donor or human leukocyte antigen mismatch.
“The presence of classic AF risk factors in the recipient plays an important role but identification of and knowledge about transplant-related factors is important,” the authors wrote. “As our understanding of transplant specific risk factors for AF increases, we may be able to better risk-stratify the kidney transplant population and develop monitoring and management strategies that can improve outcomes.”
Editor’s note: On Oct. 25, 2023, the headline of this story was updated to clarify that atrial fibrillation is more likely in adults who had hemodialysis prior to their first kidney transplant.
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