Kidney Function Monitoring in Patient with Atrial Fibrillation

Atrial fibrillation (AF) is an irregular heart rhythm that causes the heart to beat abnormally and often very fast. In many instances, AF and chronic kidney disease (CKD), a condition characterized by the sustained loss of kidney function over time, co-exist due to shared risk factors (such as diabetes and hypertension) and similar mechanisms in how both conditions develop. In a recent study published in Clinical and Experimental Nephrology, researchers sought to better understand the frequency of kidney monitoring and range of kidney function in patients with AF.

This large population-based analysis included all adult Albertans with an AF diagnosis between 2008 and 2017. CKD risk categories were defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines, using combined criteria of albuminuria (a sign of kidney disease linked to the presence of excess amounts of albumin in the urine) and estimated glomerular filtration rate (eGFR) (a blood test measuring kidney function). Based on these guidelines, patients were classified as either low, moderate, high, or very high risk. 

The researchers found that the frequency of kidney function monitoring in patients with AF increased based on the severity of KDIGO risk category, and that KDIGO guidelines were adhered to in approximately three quarters of the patient population. They further determined that only a small portion of patients had moderate to severe reductions in eGFR, most of whom remained stable over one year.  This provides reassurance that clinicians in Alberta are appropriately monitoring renal function in the majority of patients. 

This study was co-authored by the CVC’s Drs. Finlay McAslister, Roopinder Sandhu, Justin Ezekowitz, and Padma Kaul, along with Drs. Nathaniel Hawkins and Jason Andrade (University of British Columbia), Natasha Weibe (University of Alberta), and Dr. Marcello Tonelli (University of Calgary).