Dialysis-specific factors and incident atrial fibrillation in hemodialysis patients
Background Atrial fibrillation (AF) is common in end-stage renal disease patients. Besides the traditional risk factors, we aimed to find dialysis-specific factors for developing incident AF. Methods From March 2017 to August 2018, we retrospectively reviewed all outpatient-based prevalent hemodialy...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2020-01-01
|
| Series: | Renal Failure |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/0886022X.2020.1801467 |
| _version_ | 1818622124580929536 |
|---|---|
| author | Seung Don Baek Soomin Jeung Jae-Young Kang Ki Hyun Jeon |
| author_facet | Seung Don Baek Soomin Jeung Jae-Young Kang Ki Hyun Jeon |
| author_sort | Seung Don Baek |
| collection | DOAJ |
| description | Background Atrial fibrillation (AF) is common in end-stage renal disease patients. Besides the traditional risk factors, we aimed to find dialysis-specific factors for developing incident AF. Methods From March 2017 to August 2018, we retrospectively reviewed all outpatient-based prevalent hemodialysis patients in our artificial kidney room, and they were followed up until August 2019. Dialysate calcium concentration (3 versus 2.5 mEq/L), time length (4 versus 3.5 h), frequency (thrice weekly versus twice weekly), dialyzer size (effective surface area of 1.4 m2 versus 1.8 m2), membrane permeability (high flux versus low flux), ultrafiltration rate (mL/kg/hour), and blood flow rate (mL/min) were evaluated. Results Among a total of 84 patients, 15 (17.9%) had newly detected AF with a follow-up period of 21 (13.3–24) months. By performing multivariate Cox regression analysis, blood flow rate (mL/min) and ultrafiltration rate (mL/kg/h) were considered significant factors for developing incident AF (adjusted hazard ratio [HR], 0.977; p = 0.011 and adjusted HR, 1.176; p = 0.013, respectively), while dialysis bath, time length, and frequency, dialyzer size, and membrane type were not considered significant factors. Ultrafiltration cutoff rate of 8.6 mL/kg/h was the best predictive factor for incident AF (area under the curve-receiver operating characteristic [AUC-ROC], 0.746; p < 0.005), while blood flow rate was not considered a significant factor for incident AF in ROC analysis (AUC-ROC, 0.623; p = 0.126). Ultrafiltration rate was largely dependent on interdialytic weight gain (p < 0.005, linear-by-linear association). Conclusion Higher ultrafiltration rate was associated with incident AF in hemodialysis patients. |
| first_indexed | 2024-12-16T18:20:11Z |
| format | Article |
| id | doaj.art-f2ec1e20d3064cd6ba73c82fedb1ef3f |
| institution | Directory Open Access Journal |
| issn | 0886-022X 1525-6049 |
| language | English |
| last_indexed | 2024-12-16T18:20:11Z |
| publishDate | 2020-01-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Renal Failure |
| spelling | doaj.art-f2ec1e20d3064cd6ba73c82fedb1ef3f2022-12-21T22:21:35ZengTaylor & Francis GroupRenal Failure0886-022X1525-60492020-01-0142178579110.1080/0886022X.2020.18014671801467Dialysis-specific factors and incident atrial fibrillation in hemodialysis patientsSeung Don Baek0Soomin Jeung1Jae-Young Kang2Ki Hyun Jeon3Department of Internal Medicine, Division of Nephrology, Mediplex Sejong HospitalDepartment of Internal Medicine, Division of Nephrology, Mediplex Sejong HospitalDepartment of Internal Medicine, Division of Nephrology, Sejong General HospitalDepartment of Internal Medicine, Division of Cardiology, Mediplex Sejong HospitalBackground Atrial fibrillation (AF) is common in end-stage renal disease patients. Besides the traditional risk factors, we aimed to find dialysis-specific factors for developing incident AF. Methods From March 2017 to August 2018, we retrospectively reviewed all outpatient-based prevalent hemodialysis patients in our artificial kidney room, and they were followed up until August 2019. Dialysate calcium concentration (3 versus 2.5 mEq/L), time length (4 versus 3.5 h), frequency (thrice weekly versus twice weekly), dialyzer size (effective surface area of 1.4 m2 versus 1.8 m2), membrane permeability (high flux versus low flux), ultrafiltration rate (mL/kg/hour), and blood flow rate (mL/min) were evaluated. Results Among a total of 84 patients, 15 (17.9%) had newly detected AF with a follow-up period of 21 (13.3–24) months. By performing multivariate Cox regression analysis, blood flow rate (mL/min) and ultrafiltration rate (mL/kg/h) were considered significant factors for developing incident AF (adjusted hazard ratio [HR], 0.977; p = 0.011 and adjusted HR, 1.176; p = 0.013, respectively), while dialysis bath, time length, and frequency, dialyzer size, and membrane type were not considered significant factors. Ultrafiltration cutoff rate of 8.6 mL/kg/h was the best predictive factor for incident AF (area under the curve-receiver operating characteristic [AUC-ROC], 0.746; p < 0.005), while blood flow rate was not considered a significant factor for incident AF in ROC analysis (AUC-ROC, 0.623; p = 0.126). Ultrafiltration rate was largely dependent on interdialytic weight gain (p < 0.005, linear-by-linear association). Conclusion Higher ultrafiltration rate was associated with incident AF in hemodialysis patients.http://dx.doi.org/10.1080/0886022X.2020.1801467atrial fibrillationincidencerenal dialysis |
| spellingShingle | Seung Don Baek Soomin Jeung Jae-Young Kang Ki Hyun Jeon Dialysis-specific factors and incident atrial fibrillation in hemodialysis patients Renal Failure atrial fibrillation incidence renal dialysis |
| title | Dialysis-specific factors and incident atrial fibrillation in hemodialysis patients |
| title_full | Dialysis-specific factors and incident atrial fibrillation in hemodialysis patients |
| title_fullStr | Dialysis-specific factors and incident atrial fibrillation in hemodialysis patients |
| title_full_unstemmed | Dialysis-specific factors and incident atrial fibrillation in hemodialysis patients |
| title_short | Dialysis-specific factors and incident atrial fibrillation in hemodialysis patients |
| title_sort | dialysis specific factors and incident atrial fibrillation in hemodialysis patients |
| topic | atrial fibrillation incidence renal dialysis |
| url | http://dx.doi.org/10.1080/0886022X.2020.1801467 |
| work_keys_str_mv | AT seungdonbaek dialysisspecificfactorsandincidentatrialfibrillationinhemodialysispatients AT soominjeung dialysisspecificfactorsandincidentatrialfibrillationinhemodialysispatients AT jaeyoungkang dialysisspecificfactorsandincidentatrialfibrillationinhemodialysispatients AT kihyunjeon dialysisspecificfactorsandincidentatrialfibrillationinhemodialysispatients |