Factors Associated with a Large Decline in Renal Function or Progression to Renal Insufficiency in Hospitalized Atrial Fibrillation Patients with Early-Stage CKD.

Clinicians must consider renal function when administering anticoagulants for atrial fibrillation (AF). Determination of risk factors for renal function decline may enable identification of patients who require closer monitoring. We investigated the characteristics associated with renal function decline in patients with AF. The study cohort consisted of 631 AF patients who had at least one readmission during the follow-up period and stages 1-3 chronic kidney disease (CKD). The primary outcome measure was large renal function decline (>/=30% decrease from baseline estimated glomerular filtration rate [eGFR]). The secondary outcome measure was a final eGFR /= 45 mm. Among 478 patients with a baseline eGFR >/= 60 mL/minute/1.73 m(2), 137 (28.7%) progressed to renal failure (eGFR /= 75 years, CHF, lower baseline eGFR, and LAD >/= 45 mm. CHF, proteinuria, type of AF, and LAD >/= 45 mm were associated with eGFR decline >/= 30% in AF patients with CKD stages 1-3. Advanced age, CHF, lower baseline eGFR, and LAD >/= 45 mm were associated with progression to renal insufficiency. These results should be considered when identifying patients who require more frequent monitoring of eGFR.