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Open AccessArticle

Risk of Incident Non-Valvular Atrial Fibrillation after Dialysis-Requiring Acute Kidney Injury

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Division of Nephrology, Department of Internal Medicine, Saint Mary’s Hospital Luodong, Loudong 265, Yilan, Taiwan
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Saint Mary’s Junior College of Medicine, Nursing and Management, Sanxing Township, Yilan County 266, Taiwan
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Division of Nephrology, Department of Internal medicine, Chi Mei Medical Center, Yongkang District, Tainan City 710, Taiwan
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Department of Biological Science and Technology, Chung Hwa University of Medical Technology, Rende District, Tainan City 717, Taiwan
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Division of Nephrology, Department of Internal Medicine, Chi Mei Medical Center, Liouying, Tainan City 736, Taiwan
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Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei 106, Taiwan
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Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
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Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100, Taiwan
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Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Miaoli County 350, Taiwan
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Case Western Reserve University, No. 10900 Euclid Ave., Cleveland, OH 44106, USA
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Department of Nursing, Saint Mary’s Hospital Luodong, Loudong 265, Yilan, Taiwan
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Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
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NSARF, National Taiwan University Study Group on Acute Renal Failure
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Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(9), 248; https://doi.org/10.3390/jcm7090248
Received: 20 July 2018 / Revised: 27 August 2018 / Accepted: 29 August 2018 / Published: 29 August 2018
The influence of acute kidney injury (AKI) on subsequent incident atrial fibrillation (AF) has not yet been fully addressed. This retrospective nationwide cohort study was conducted using Taiwan’s National Health Insurance Research Database from 1 January 2000 to 31 December 2010. A total of 41,463 patients without a previous AF, mitral valve disease, and hyperthyroidism who developed de novo dialysis-requiring AKI (AKI-D) during their index hospitalization were enrolled. After propensity score matching, “non-recovery group” (n = 2895), “AKI-recovery group” (n = 2895) and “non-AKI group” (control group, n = 5790) were categorized. Within a follow-up period of 6.52 ± 3.88 years (median, 6.87 years), we found that the adjusted risks for subsequent incident AF were increased in both AKI-recovery group (adjusted hazard ratio (aHR) = 1.30; 95% confidence intervals (CI), 1.07–1.58; p ≤ 0.01) and non-recovery group (aHR = 1.62; 95% CI, 1.36–1.94) compared to the non-AKI group. Furthermore, the development of AF carried elevated risks for major adverse cardiac events (aHR = 2.11; 95% CI, 1.83–2.43), ischemic stroke (aHR = 1.33; 95% CI, 1.19–1.49), and all stroke (aHR = 1.28; 95% CI, 1.15–1.43). (all p ≤ 0.001, except otherwise expressed) The authors concluded that AKI-D, even in those who withdrew from temporary dialysis, independently increases the subsequent risk of de novo AF. View Full-Text
Keywords: acute kidney injury; adverse cardiovascular events; atrial fibrillation; dialysis acute kidney injury; adverse cardiovascular events; atrial fibrillation; dialysis
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Shiao, C.-C.; Kan, W.-C.; Wang, J.-J.; Lin, Y.-F.; Chen, L.; Chueh, E.; Huang, Y.-T.; Chiang, W.-P.; Tseng, L.-J.; Wang, C.-H.; Wu, V.-C. Risk of Incident Non-Valvular Atrial Fibrillation after Dialysis-Requiring Acute Kidney Injury. J. Clin. Med. 2018, 7, 248.

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