Management of Adults with Newly Diagnosed Atrial Fibrillation with and without CKD

BACKGROUND: Atrial fibrillation (AF) is highly prevalent in CKD and is associated with worse cardiovascular and kidney outcomes. Limited data exist on use of AF pharmacotherapies and AF-related procedures by CKD status. We examined a large “real-world” contemporary population with incident AF to study the association of CKD with management of AF. METHODS: We identified patients with newly diagnosed AF between 2010 and 2017 from two large, integrated health care delivery systems. eGFR (≥60, 45–59, 30–44, 15–29, 60 ml/min per 1.73 m(2), patients with eGFR 30–44 (adjusted hazard ratio [aHR] 0.91; 95% CI, 0.99 to 0.93), 15–29 (aHR, 0.78; 95% CI, 0.75 to 0.82), and 60 ml/min per 1.73 m(2). These associations were even stronger for eGFR 60 ml/min per 1.73 m(2)): eGFR 30–44 ml/min per 1.73 (aHR, 0.78; 95% CI, 0.70 to 0.87), eGFR 15–29 ml/min per 1.73 m(2) (aHR, 0.73; 95% CI, 0.61 to 0.88), and eGFR