What is the clinical evidence from this study?

Study design: Cohort. Population: End-stage renal disease (n=5326). Intervention: Risk factors (age, obesity, coronary artery disease). Primary outcome: New-onset atrial fibrillation (OR 1.678, 95% CI 1.466-1.920, p=<0.0001).

What question did this study set out to answer?

This research aims to identify factors predicting new-onset atrial fibrillation in end-stage renal disease patients undergoing dialysis.

April 12, 2026Open Access

The Predictors of New-Onset Atrial Fibrillation in End-Stage Renal Disease Patients: A Multi-Center Retrospective Observational Study

Q: What are the key findings of this study?

Increasing age, obesity, and coronary artery disease (OR 1.678; 95% CI 1.466-1.920) were significant predictors of new-onset atrial fibrillation in end-stage renal disease patients on dialysis.

Q: What question did this study set out to answer?

This research aims to identify factors predicting new-onset atrial fibrillation in end-stage renal disease patients undergoing dialysis.

Key Result

Increasing age, obesity, and coronary artery disease (OR 1.678; 95% CI 1.466-1.920) were significant predictors of new-onset atrial fibrillation in end-stage renal disease patients on dialysis.

Key Points

This research aims to identify factors predicting new-onset atrial fibrillation in end-stage renal disease patients undergoing dialysis.
Conducted a retrospective multicenter cohort study within the Northwell Health System.
Analyzed data from 5326 ESRD patients on dialysis from 2017 to 2019.
Utilized multivariable-adjusted logistic regression to evaluate potential predictors of new-onset AF.
1564 out of 5326 patients (29.4%) developed new-onset atrial fibrillation.
Key predictors included increasing age (OR 1.038), obesity (OR 1.208), and coronary artery disease (OR 1.678).
African American patients showed lower odds of developing AF compared to White patients (OR 0.578).

Study Design

Type

Cohort (n=5,326)

Multicenter

Yes

Structured PICO

Population

5326 end-stage renal disease (ESRD) patients on dialysis within the Northwell Health System between 2017 and 2019, mean age 64.2 ± 13.1 years, 48.3% females.

Outcome

New-onset atrial fibrillationhard clinical

Age, obesity, and coronary artery disease are significant predictors of new-onset atrial fibrillation in end-stage renal disease patients on dialysis.

Main Result

Effect estimate: OR 1.678 (95% CI 1.466-1.920)

p-value: p=<0.0001

Abstract

Background/Objectives: Atrial fibrillation (AF) is a significant and prevalent cardiovascular complication in end-stage renal disease (ESRD) patients, yet its specific predictors within this population are not well understood. This study aimed to identify the predictors of new-onset AF in ESRD patients undergoing dialysis. Methods: We conducted a retrospective multicenter cohort study within the Northwell Health System, analyzing data from 5326 ESRD patients on dialysis between 2017 and 2019. The mean age was 64.2 ± 13.1 years, with 48.3% females. Multivariable-adjusted logistic regression was used to identify predictors of new-onset AF, the primary outcome. Adjusted odds ratios (ORs) were calculated for potential risk factors. Results: Of the 5326 patients, 1564 (29.4%) developed new-onset AF. Significant predictors included increasing age (OR 1.038 per year, 95% CI 1.032–1.044, p 30 vs. BMI 20–25: OR 1.208, 95% CI 1.026–1.422, p = 0.023), and coronary artery disease (OR 1.678, 95% CI 1.466–1.920, p < 0.0001). African American patients had lower odds of developing AF compared to White patients (OR 0.578, 95% CI 0.494–0.676, p < 0.0001). Hypertension, sex, diabetes, and tobacco use were not significantly associated with AF risk. Conclusions: Age, obesity, and coronary artery disease are significant predictors of new-onset AF in ESRD patients on dialysis. Notable racial disparities exist, with African American patients having a lower risk. These findings may inform targeted prevention strategies and guide future research into the mechanisms underlying AF in ESRD patients.