Atrial Fibrillation and Chronic Kidney Disease: Aetiology and Management

Bharat Sidhu; Akash Mavilakandy; Katherine L Hull; Ivelin Koev; Zakariyya Vali; James O Burton; G André Ng

doi:10.31083/j.rcm2504143

Atrial Fibrillation and Chronic Kidney Disease: Aetiology and Management

Rev Cardiovasc Med. 2024 Apr 9;25(4):143. doi: 10.31083/j.rcm2504143. eCollection 2024 Apr.

Authors

Bharat Sidhu¹, Akash Mavilakandy^{1

2}, Katherine L Hull^{1

3}, Ivelin Koev^{1

2}, Zakariyya Vali^{1

2}, James O Burton^{1

3

4}, G André Ng^{1

2

5}

Affiliations

¹ Department of Cardiovascular Sciences, University of Leicester, LE1 7RH Leicester, UK.
² Department of Cardiology, University Hospitals of Leicester NHS Trust, LE1 5WW Leicester, UK.
³ John Walls Renal Unit, Leicester General Hospital, LE5 4PW Leicester, UK.
⁴ School of Sport, Exercise and Health Sciences, Loughborough University, LE11 3TU Loughborough, UK.
⁵ National Institute for Health Research Leicester Biomedical Research Centre, LE3 9QP Leicester, UK.

Abstract

Chronic kidney disease (CKD) and atrial fibrillation (AF) are associated with significant cardiovascular morbidity and mortality. Recent studies have highlighted an increased prevalence and incidence of AF in patients with CKD. This article aims to provide a comprehensive review of current management strategies and considerations of treating atrial fibrillation with concomitant CKD. Potential electrophysiological mechanisms between AF and CKD are explored. Current evidence and literature focusing on pharmacological rate and rhythm control along with procedural intervention is reviewed and presented. The management of AF and CKD together is complex, but particularly pertinent when considering the close cyclical relationship in the progression of both diseases.

Keywords: anticoagulation; atrial fibrillation; chronic kidney disease.

Publication types

Review

Grants and funding

G.A.N. has been supported by a British Heart Foundation Programme Grant (RG/17/3/32774) and the Medical Research Council Biomedical Catalyst Developmental Pathway Funding Scheme (MR/S037306/1).