Adults receiving hemodialysis at higher risk of developing AF versus peritoneal dialysis

The study led to the following findings:

· Of 43,621 patients, 84.9% received hemodialysis and 15.1% received peritoneal dialysis before transplant. The mean dialysis ‘vintage’ was 4.3 yrs.

· Atrial fibrillation occurred in 286 patients who received peritoneal dialysis over 15,363 person-years and 2315 patients who received hemodialysis over 83,536 person-years before kidney transplant.

· After multivariable adjustment, atrial fibrillation was 20% more likely in those who had been receiving hemodialysis vs. peritoneal dialysis, regardless of whether death was considered a competing risk or a censoring event.

· Each year of pre-transplant dialysis vintage increased the risk of post-transplant atrial fibrillation by 6%.

The researchers also highlighted other factors associated with developing post-transplant AF, such as a previous solid organ transplant, human leukocyte antigen mismatch or female donor.

"We found that patients receiving hemodialysis before transplantation were at greater risk of developing new-onset post-kidney transplant AF versus patients who were receiving peritoneal dialysis," the researchers wrote.

"The presence of classic AF risk factors in the recipient plays a critical role but identification of and knowledge about transplant-related factors is important."

"With the increase in our understanding of transplant-specific risk factors for AF, we may be able to better risk-stratify the kidney transplant population and develop management and monitoring strategies that can improve outcomes," they concluded.

Reference:

Garcia LP, et al. Kidney Med. 2023;doi.org/10.1016/j.xkme.2023.100741.