Hemodialysis before kidney transplant increases risk for AF vs. peritoneal dialysis
Click Here to Manage Email Alerts
Key takeaways:
- Newly diagnosed cases of atrial fibrillation occurred in 286 patients who received peritoneal dialysis.
- Comparatively, 2,315 patients treated with hemodialysis were diagnosed with atrial fibrillation.
Patients who receive hemodialysis vs. peritoneal dialysis before kidney transplantation may be at higher risk for developing atrial fibrillation after the transplant, a study found.
“The prevalence of [atrial fibrillation (AF)] is higher in the kidney failure population than in the general population and its incidence increases with lower [eGFR] and increasing proteinuria,” Leonardo Pozo Garcia, MD, of the section of nephrology, department of medicine at Baylor College of Medicine in Houston, wrote with colleagues. “Individuals with kidney failure receiving dialysis are at particularly high risk of AF.”
Using data from the United States Renal Data System, researchers retrospectively identified 43,621 adult Medicare-insured patients who had not previously been diagnosed with AF, and who received an initial kidney transplant between Jan. 1, 2005, and Sept. 30, 2012.
The aim of the study was to determine the relationship between pretransplant dialysis modality and post-transplant AF with the main outcome being time AF occurrence up to 3 years post-transplant. Of the included patients, 84.9% had hemodialysis before the transplant, while 15.1% received peritoneal dialysis.
While the authors said the study had limitations, including residual confounding and unspecified AF data from billing claims, the researchers found the findings significant. Newly diagnosed AF occurred in 286 patients who received peritoneal dialysis and in 2,315 patients who were treated with hemodialysis, according to the results.
After adjusting for various factors, investigators found that patients receiving hemodialysis were 20% more likely to develop AF after the transplant, regardless of whether death was considered a competing risk or a censoring event. Additionally, the findings highlighted, each year of pretransplant dialysis vintage increased the risk by 6%.
“As our understanding of transplant-specific risk factors for AF increases, we may be able to better risk-stratify transplant patients and develop monitoring and management strategies that can improve outcomes,” Garcia and colleagues wrote.
Collapse
Click Here to Manage Email Alerts