Irregular heart beat elevates risk of kidney failure

UCSF/Kaiser Permanente study shows link between atrial fibrillation and end-stage renal disease among people with chronic kidney disease

2013-01-18

(Press-News.org) Many people who suffer from chronic kidney disease progressively lose their kidney function over time and eventually develop a condition called end-stage renal disease – the complete failure of the kidneys – placing them in need of lifelong dialysis or a kidney transplant.

Now researchers at the University of California, San Francisco (UCSF) and the Kaiser Permanente Northern California Division of Research have found that the risk of kidney failure is greater for people with chronic kidney disease who also have atrial fibrillation, one of the most common forms of irregular heart rhythm in adults.

The finding opens the way for further studies into the relationship between the two factors, which could lead to new treatment approaches that would improve outcomes for people with chronic kidney disease.

Doctors have known that patients with chronic kidney disease or end-stage renal disease commonly have atrial fibrillation and as a result are more likely to have a stroke or to die. However, the long-term impact of atrial fibrillation on kidney function among patients with known chronic kidney disease has been unknown.

The new study, published last month in the journal Circulation, involved 206,229 adults with chronic kidney disease who were drawn from members of Kaiser Permanente Northern California, a large integrated health care delivery system.. Over the course of about five years, approximately 16,400 patients developed atrial fibrillation, and those who did were 67 percent more likely to progress to end-stage renal disease compared with patients who had chronic kidney disease but did not develop atrial fibrillation

"These novel findings expand on previous knowledge by highlighting that atrial fibrillation is linked to a worse kidney prognosis in patients with underlying kidney dysfunction," said kidney specialist Nisha Bansal, MD, an assistant professor in the Division of Nephrology at UCSF.

"There is a knowledge gap about the long-term impact of atrial fibrillation on the risk of adverse kidney-related outcomes in patients with chronic kidney disease," said senior author Alan S. Go, MD, director of the Comprehensive Clinical Research Unit at the Kaiser Permanente Division of Research. "This study addresses that gap and may have important implications for clinical management by providing better prognostic information and leading to future work determining how to improve outcomes in this high-risk group of patients."

UCSF is one of the world's leading centers for kidney disease treatment, research and education. Its Division of Nephrology is ranked among the best programs in the nation by U.S. News & World Report.

Beating the Odds

People who have chronic kidney disease fall into a spectrum in terms of how severe their disease is. At one end are those who have very minor loss of kidney function. They may not have any symptoms at all, and only by applying a simple blood test can doctors properly diagnose their disease.

At the other end of the spectrum are the people who have progressed to end-stage renal disease, which is basically complete kidney failure. They require lifelong dialysis or a kidney transplant. Some people progress rapidly to end-stage renal disease while others may live for decades without ever progressing.

Doctors are interested in understanding the factors that place patients at greater risk for end-stage renal disease, Bansal said, because it may be possible to address those factors through medications or lifestyle changes like diet or exercise.

Bansal added, however, that while the two conditions are intertwined, scientists do not know exactly which specific genes, pathways and biological mechanisms connect irregular heartbeat to declines in kidney function. Neither do they yet know the extent to which treating atrial fibrillation will improve outcomes for people with chronic kidney disease.

INFORMATION:

The article, "Incident Atrial Fibrillation and Risk of End-Stage Renal Disease in Adults with Chronic Kidney Disease" is authored by Nisha Bansal, Dongjie Fan, Chi-yuan Hsu, Juan D. Ordonez, Gregory M. Marcus and Alan S. Go. It was published online by the journal Circulation on Dec. 28, 2012. See: http://dx.doi.org/10.1161/CIRCULATIONAHA.112.123992

This work was funded by the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) and the National Heart, Lung and Blood Institute (NHLBI) through grant #K23 DK088865, #K24 DK92291, #5U01 DK060902, #5U19 HL091179 and #5 RC2 HL101589. Both NIDDK and NHLBI are components of the National Institutes of Health.

UCSF is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care.

The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and the society at large. It seeks to understand the determinants of illness and well-being and to improve the quality and cost-effectiveness of health care. Currently, DOR's 600-plus staff is working on more than 250 epidemiological and health services research projects. For more information, visit www.dor.kaiser.org.

Follow UCSF

UCSF.edu | Facebook.com/ucsf | Twitter.com/ucsf | YouTube.com/ucsf

[Attachments] See images for this press release:

ELSE PRESS RELEASES FROM THIS DATE:

Power's punishing impact

2013-01-18

Often, employees are shocked by what they think is a supervisor's severe reaction to a subordinate's seemingly minor transgression. The supervisors who punish them seem to be so absolutely sure that they are doing the right thing—they have a clear sense of purpose and there are no arguments to sway them. New research by Scott Wiltermuth, a USC Marshall School of Business assistant professor of management and organization, and co-author Francis Flynn of the Stanford Graduate School of Business, found that providing a sense of power to someone instills a black-and-white ...

Mayo Clinic researchers identify enzyme involved in deadly brain tumors

2013-01-18

ROCHESTER, Minn. -- One of the most common types of brain tumors in adults, glioblastoma multiforme, is one of the most devastating. Even with recent advances in surgery, radiation and chemotherapy, the aggressive and invasive tumors become resistant to treatment, and median survival of patients is only about 15 months. In a study published in Neuro-Oncology, researchers at Mayo Clinic identify an important association between the naturally occurring enzyme Kallikrein 6, also known as KLK6, and the malignant tumors. "Our study of Kallikrein 6 showed that higher levels ...

Botox beats steroids for painful foot condition, plantar fasciitis

2013-01-18

Los Angeles, CA (January 17, 2013) - Plantar fasciitis is the most frequent cause of chronic heel pain, leaving many sufferers unable to put their best foot forward for months at a time. Now a Mexican study suggests that physicians should turn to Botox rather than steroids to offer patients the fastest road to recovery. The research appears in the journal Foot & Ankle International, published by SAGE. Plantar fasciitis results when connective tissues on the sole of the foot, the plantar fascia, become painfully inflamed. Physicians may suggest various therapies for this ...

Questions about biosafety? Ask a biosafety expert

2013-01-18

WASHINGTON— The rapid decline in costs associated with many common laboratory techniques, such as DNA sequencing and synthesis, has led to their adoption by individuals outside of traditional university or industrial settings, giving rise to a rapidly growing Do-It-Yourself Biology (DIYbio) community. DIYbio.org and the Synthetic Biology Project at the Woodrow Wilson Center this week are launching the "Ask a Biosafety Expert" service in order to provide this emerging DIYbio community with free and timely access to professional biosafety advice. The project comes amidst ...

Why wolves are forever wild, but dogs can be tamed

2013-01-18

AMHERST, Mass. – Dogs and wolves are genetically so similar, it's been difficult for biologists to understand why wolves remain fiercely wild, while dogs can gladly become "man's best friend." Now, doctoral research by evolutionary biologist Kathryn Lord at the University of Massachusetts Amherst suggests the different behaviors are related to the animals' earliest sensory experiences and the critical period of socialization. Details appear in the current issue of Ethology. Until now, little was known about sensory development in wolf pups, and assumptions were usually ...

Health and law expert: NFL not alone in handling concussions as 'benign' problems

2013-01-18

INDIANAPOLIS -- More than 2,000 former football players are suing the National Football League, saying the league should have taken action earlier to deal with injuries related to concussions more seriously. But if a lack of speed in tackling concussions warrants criticism, the NFL isn't the only player deserving a penalty, according to a study co-authored by health care and law expert David Orentlicher, who teaches at Indiana University Robert H. McKinney School of Law in Indianapolis. Neurologists were also slow in sounding the alarm, and for decades, concussions ...

New study challenges links between day care and behavioral issues

2013-01-18

CHESTNUT HILL, MA (Jan. 17, 2013) – A new study that looked at more than 75,000 children in day care in Norway found little evidence that the amount of time a child spends in child care leads to an increase in behavioral problems, according to researchers from the United States and Norway. Several prior studies in the U.S. made connections between the time a child spends in day care and behavioral problems, but the results from Norway contradict those earlier findings, the researchers report in the online version of the journal Child Development. "In Norway, we do not ...

Study findings have potential to prevent,reverse disabilities in children born prematurely

2013-01-18

PORTLAND, Ore. – Physician-scientists at Oregon Health & Science University Doernbecher Children's Hospital are challenging the way pediatric neurologists think about brain injury in the pre-term infant. In a study published online in the Jan. 16 issue of Science Translational Medicine, the OHSU Doernbecher researchers report for the first time that low blood and oxygen flow to the developing brain does not, as previously thought, cause an irreversible loss of brain cells, but rather disrupts the cells' ability to fully mature. This discovery opens up new avenues for potential ...

Want to ace that interview? Make sure your strongest competition is interviewed on a different day

2013-01-18

Whether an applicant receives a high or low score may have more to do with who else was interviewed that day than the overall strength of the applicant pool, according to new research published in Psychological Science, a journal of the Association for Psychological Science. Drawing on previous research on the gambler fallacy, Uri Simonsohn of The Wharton School of the University of Pennsylvania and Francesca Gino of Harvard Business School hypothesized that admissions interviewers would have a difficult time seeing the forest for the trees. Instead of evaluating applicants ...

In minutes a day, low-income families can improve their kids' health

2013-01-18

URBANA – When low-income families devote three to four extra minutes to regular family mealtimes, their children's ability to achieve and maintain a normal weight improves measurably, according to a new University of Illinois study. "Children whose families engaged with each other over a 20-minute meal four times a week weighed significantly less than kids who left the table after 15 to 17 minutes. Over time, those extra minutes per meal add up and become really powerful," said Barbara H. Fiese, director of the U of I's Family Resiliency Program. Childhood obesity ...

Irregular heart beat elevates risk of kidney failure

ELSE PRESS RELEASES FROM THIS DATE:

LAST 30 PRESS RELEASES: