Clinical characteristics associated to atrial fibrillation in chronic hemodialysis patients

Fabbian, F Catalano, C Lambertini, D Tarroni, G Bordin, V Squerzanti, R Gilli, P Di Landro, D Cavagna, R

F. Fabbian et al., Clinical characteristics associated to atrial fibrillation in chronic hemodialysis patients, CLIN NEPHR, 54(3), 2000, pp. 234-239

25

INGLESE

Article

Urology & Nephrology","da verificare

CLINICAL NEPHROLOGY

0301-0430 → ACNP

54

3

2000

234 - 239

ISI

0301-0430(200009)54:3<234:CCATAF>2.0.ZU;2-X

Background: Atrial fibrillation (AF) is the most common sustained arrhythmi a diagnosed in non-uremic patients and its prevalence increases in older su bjects, however, information concerning AP in dialysis patients is scarce. Therefore, we carried out a prospective cross-sectional study from Septembe r 1996 to December 1996 in order to evaluate the prevalence and some of the clinical characteristics associated to AF in hemodialysis (HD) patients. S ubjects and methods: 316 HD patients (age 63 +/- 12 years, dialysis duratio n 69 +/- 71 months) treated in three different hospital-based units were st udied. Standard 12-lead electrocardiograms (ECGs) carried out in the interd ialytic day during the study period were reviewed. Data concerning age, his tory of ischemic heart disease (IHD), cerebrovascular disease (CVD), periph eral vascular disease (PVD), presence of diabetes, smoking history and anti hypertensive therapy were collected. Systolic and diastolic blood pressure, fasting cholesterol and triglycerides, albumin and hemoglobin were also de rived from the clinical records. Performance status was assessed by Karnofs ky index (Ki). Results: 74 patients (23.4%) had persistent AF, i.e, presenc e of AF in all (at least two) ECGs performed in the study time. Patients wi th AF were older (age 69+/- 10 vs 62+/-12 years, p <0.001), had lower Ki (5 4 +/- 20 vs 68 +/- 17, p < 0,01), cholesterol (182+/- 46 vs 198 +/- 52 mg/d l, p < 0.01) and albumin (3.9 +/- 0.5 vs 4.1 +/- 0.5 g/dl, p < 0.001) compa red to those with no AF. Prevalence of IHD (44.5% vs 19%, p < 0.05) and PVD (23% vs 11%, p < 0.05) was higher among AF patients. Logistic regression a nalysis showed that IHD (p < 0.001) and Ki (p < 0.01) were independently as sociated to AF. Conclusion: We conclude that AF is a frequent arrhythmia in HD patients treated in hospital-based dialysis units, especially in those with low performance status. It appears to be associated to the atheroscler otic damage of coronary arterial tree. Prospective studies are necessary to assess whether it could contribute to cardiovascular morbidity and mortali ty in end-stage renal disease.