Clinical outcomes among hemodialysis patients with atrial fibrillation: a Korean nationwide population-based study
The number of patients requiring dialysis is increasing worldwide, and the atrial fibrillation and atrial flutter (AF) prevalence among hemodialysis (HD) patients is higher than in the general population. There have been no studies of Korean AF patients undergoing HD that investigated how AF affects...
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Published in | Kidney research and clinical practice Vol. 40; no. 1; pp. 99 - 108 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Korea (South)
The Korean Society of Nephrology
01.03.2021
대한신장학회 |
Subjects | |
Online Access | Get full text |
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Summary: | The number of patients requiring dialysis is increasing worldwide, and the atrial fibrillation and atrial flutter (AF) prevalence among hemodialysis (HD) patients is higher than in the general population. There have been no studies of Korean AF patients undergoing HD that investigated how AF affects outcomes, such as all-cause mortality, hospitalization, and stroke events. We conducted a large-scale retrospective cohort study with data from the National Health Insurance System to determine how AF affects these outcomes.
In 2013, the Health Insurance Review and Assessment service, a Korean national health insurance scheme, collected data from 21,839 HD patients to evaluate the adequacy of dialysis centers. All-cause mortality, hospitalization, and stroke events were compared between patients with and without AF. Sub-analyses compared these outcomes between AF patients receiving warfarin and those not receiving warfarin.
Cox regression analysis found that AF was a significant risk factor for death from any cause (hazard ratio [HR], 1.356; 95% confidence interval [CI], 1.222-1.506; p < 0.001), hospitalization (HR, 1.323; 95% CI, 1.225-1.430; p < 0.001), and hemorrhagic stroke (HR, 1.500; 95% CI, 1.050-2.141; p = 0.026). AF was not significantly associated with an increased risk of ischemic stroke. The use of warfarin was significantly associated with hemorrhagic stroke incidence (HR, 1.593; 95% CI, 1.075-2.360; p = 0.020), while there was no significant correlation between warfarin treatment and all-cause mortality, hospitalization, and ischemic stroke.
This cohort study of Korean dialysis patients showed that AF was a risk factor for multiple outcomes among HD patients. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Editor: Eun Hui Bae, Chonnam National University, Gwangju, Republic of Korea |
ISSN: | 2211-9132 2211-9140 |
DOI: | 10.23876/j.krcp.20.022 |