Predialysis Nephrology Care Associated With Lower AFib Risk

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Older patients who had more frequent nephrology visits prior to initiating dialysis had a lower incidence of atrial fibrillation in the year after initiating dialysis compared with those who did not.
Older patients who had more frequent nephrology visits prior to initiating dialysis had a lower incidence of atrial fibrillation in the year after initiating dialysis compared with those who did not.
The following article is part of conference coverage from the NKF 2018 Spring Clinical Meetings in Austin hosted by the National Kidney Foundation. Renal & Urology News staff will be reporting on medical studies conducted by nephrologists and other specialists who are tops in their field in chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from NKF 2018.

AUSTIN, Texas—Atrial fibrillation is less likely to develop among older patients with end-stage renal disease (ESRD) who initiate dialysis after having received predialysis nephrology care, according to study findings presented at the National Kidney Foundation's 2018 Spring Clinical Meetings.

In a study of 284,540 ESRD patients aged 67 to 99 years who started dialysis from 1996 to 2011, patients who had a nephrologist visit prior to initiating dialysis had a lower incidence of AF compared with those who did not, after adjusting for potential confounders, Samaya Qureshi, MD, and colleagues from the Baylor College of Medicine in Houston, Texas, reported.

Of the 284,540 patients, 187,344 (65.8%) received predialysis nephrology care and 97,196 (34.2%) did not. During 213,071 person-year of follow-up, 42,442 patients were newly diagnosed with AF, 1394 received a kidney transplant, and 68,813 died, Dr Qureshi's team reported. Compared with patients who had no predialysis nephrology care, those who had 1–4, 5–9, and 10 or more nephrology visits had a lower incidence of AF, with patients who had 10 visits or more experiencing an 18% reduction in risk.

“This study further highlights the importance of pre-ESRD nephrology care and may encourage nephrologists to improve screening for AF during visits which may ultimately lead to better long-term outcomes,” the authors concluded.

The investigators note that, to their knowledge, this study is the first to examine the association between patterns of predialysis nephrology care and incident AF in older patients with ESRD initiating dialysis.

See more coverage from the National Kidney Foundation Spring Clinical meeting

Reference

Qureshi S, Erickson K, Airy M, et al. Predialysis nephrology care and incident atrial fibrillation in older patients with ESRD initiating dialysis. Data presented at the National Kidney Foundation 2018 Spring Clinical Meetings held in Austin, Texas, from April 10–14. Poster 185.

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