Background: Lower estimated glomerular filtration rate (eGFR), in particular in the range of significant renal impairment (60 ml/min/1.73m2>eGFR), is associated with incident atrial fibrillation (AF). This association is less clear within the normal or mildly impaired range.
Methods: Using the Chronic Kidney Disease EPIdemiology collaboration (CKD-EPI) eGFR formula, we analyzed ambulatory adults (>22 years old) without rheumatic heart disease or prosthetic valves and with 60 ml/min/1.73m2
Results: The mean age of our cohort (n=1,331,670) was 49.1± 16.4 years, with a male/female ratio of 0.77; 29.5% and 10.9% had hypertension and diabetes mellitus, respectively. We also analyzed the cohort, excluding individuals with prior CVD (n=1,275,887). Over a mean of 108 months and >10 million patient-years of follow-up, >65,000 individuals had at least one AF event (incident AF rate 5.8% and 5.2% including or excluding prior CVD, respectively). Adjusting for age, gender, hypertension and diabetes mellitus, a 10-unit increase in eGFR was independently associated with a mean decrease in incident AF of 2.6% in the entire cohort and 1.5% excluding those with prior CVD (p2
Conclusion: Higher eGFR is independently associated with lesser incident non-valvular AF in adults with and without prior CVD, particularly in the 100 ml/min/1.73m2
