New-onset atrial fibrillation in patients with acute kidney injury on continuous renal replacement therapy.

Abstract

PURPOSE:

The mortality of critically ill patients with acute kidney injury (AKI) who require continuous renal replacement therapy (CRRT) remains high. We assessed the incidence and predictors of new-onset atrial fibrillation (NOAF) in this population and its impact on outcomes.

MATERIALS AND METHODS:

This is a retrospective cohort study of adult intensive care units (ICU) patients who had AKI and received CRRT from December 2006 through November 2015 in a tertiary academic medical center. Cox proportional hazard model was used to evaluate the impact of NOAF on overall mortality.

RESULTS:

Out of 1398 screened patients, NOAF occurred in 193 (14%) cases. NOAF occurring on CRRT was independently associated with an increased hazard of death at follow-up (HR: 1.26; 95% CI: 1.03-1.56), compared to the group who did not have NOAF. In the multivariable analysis using time-dependent covariates, higher potassium (HR 1.24, 95%CI: 1.01-1.54) and bicarbonate (HR 0.95, 95%CI: 0.92-0.98) levels were associated with increased and decreased risk of NOAF on CRRT, respectively.

CONCLUSIONS:

NOAF in critically ill patients with AKI receiving CRRT is common and carries an unfavorable prognosis. Prospective studies are required to elucidate modifiable risk factors for NOAF occurring on CRRT.

• Authors: Khaled Shawwa, Panagiotis Kompotiatis, Shane A Bobart, Kristin C Mara, Brandon M Wiley, Jacob C Jentzer, Kianoush B Kashani
• Journal: Journal of critical care (J Crit Care) Vol. 62 Pg. 157-163 (04 2021) ISSN: 1557-8615 [Electronic] United States
• PMID: 33383309 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2020 Elsevier Inc. All rights reserved.

Topics

• Acute Kidney Injury (epidemiology, therapy)
• Adult
• Atrial Fibrillation (epidemiology, therapy)
• Continuous Renal Replacement Therapy
• Critical Illness
• Humans
• Intensive Care Units
• Renal Replacement Therapy
• Retrospective Studies