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International Urology and Nephrology
Published in: International Urology and Nephrology 8/2020

01-08-2020 | Atrial Fibrillation | Nephrology - Original Paper

The CHA2DS2-VASc score predicts chronic kidney disease among patients with atrial fibrillation

Authors: Chih-Jen Wang, Yao-Peng Hsieh, Chew-Teng Kor, Ping-Fang Chiu

Published in: International Urology and Nephrology | Issue 8/2020

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Abstract

Background

It is unclear how the CHA2DS2-VASc score can predict subsequent chronic kidney disease (CKD) and end-stage renal disease (ESRD) among atrial fibrillation (AF) patients.

Methods

We identified incident AF patients without CKD between 2000 and 2013 from the National Health Insurance Research Database (NHIRD) of Taiwan and calculated the CHA2DS2-VASc score for each patient. Adjusted hazard ratio (HR) with 95% confidence interval (CI) was estimated from multivariate cause-specific Cox models to assess the risk of CKD and ESRD associated with the CHA2DS2-VASc score.

Results

A total of 8764 participants with AF who did not have CKD were included in the analysis. The mean age was 69.63 ± 13.48 years and 4800 (54.8%) were males. The adjusted HR of CKD displayed a stepwise increase with the increase in the CHA2DS2-VASc score. When compared with those with a CHA2DS2-VASc score of 0, the adjusted HRs of CKD were 1.57 (95% CI 1.09–2.26), 2.04 (95% CI 1.42–2.94), 2.48 (95% CI 1.70–3.62), 2.88 (95% CI 1.95–4.26), 3.29 (95% CI 2.18–4.95) and 4.00 (95% CI 2.61–6.13) for the AF patients with a CHA2DS2-VASc score of 1, 2, 3, 4, 5 and ≥ 6, respectively. Similarly, as the CHA2DS2-VASc score increased, the adjusted HR of ESRD showed a gradual increase.

Conclusions

Patients with a higher CHA2DS2-VASc score were linked to a higher risk of CKD and ESRD in a dose-dependent effect, i.e. the incidence of CKD/ESRD increased with the increasing CHA2DS2-VASc score.
Appendix
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Metadata
Title
The CHA2DS2-VASc score predicts chronic kidney disease among patients with atrial fibrillation
Authors
Chih-Jen Wang
Yao-Peng Hsieh
Chew-Teng Kor
Ping-Fang Chiu
Publication date
01-08-2020
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 8/2020
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-020-02514-x

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