Fluctuating renal function and the risk of incident atrial fibrillation: a nationwide population-based study

Figures

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  Figure 1. The cumulative incidences of incident atrial fibrillation by the quartiles of GFR-VIM. Compared to the individuals with the lowest variability of renal function (Q1), those with the highest variability of renal function (Q4) had higher crude incidence rates of atrial fibrillation. Abbreviation: AF = atrial fibrillation; eGFR = estimated glomerular filtration rate calculated by MDRD equation; GFR-VIM = variability independent of mean of eGFR.

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  Figure 2. The risks of incident atrial fibrillation by the quartiles of GFR-VIM. With an adjusted model, the risk of incident AF was significantly increased in the group with the highest variability of renal function (Q4). For the individuals with a middle range of GFR-VIM (Q2 and Q3), there were no significant differences in AF risk compared to the group with the lowest variability of renal function (Q1). Abbreviation: CI = confidence interval; AF = atrial fibrillation; eGFR = estimated glomerular filtration rate calculated by MDRD equation; GFR-VIM = variability independent of mean of eGFR; HR = hazard ratio, adjusted by Model 2 (age, sex, smoking status, alcohol consumption, regular physical activity, low income level, body-mass index, hypertension, diabetes, and baseline eGFR); IR = incidence rate in 1,000 person-years.

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  Figure 3. The risks of incident atrial fibrillation by various subgroups. Most subgroup analyses showed consistency with the main results, whereas age strata, sex, and eGFR trends showed significant interactions. For the subgroups of age strata, an increasing trend for developing AF risk was observed in older subjects. Males showed a higher risk of AF in those with higher eGFR variability. Among the subgroups by eGFR trends, only the subjects with a decreased eGFR trend had a significantly higher risk of AF in those with higher eGFR variability. Abbreviation: AF = atrial fibrillation; CI = confidence interval; CKD = chronic kidney disease; eGFR = estimated glomerular filtration rate calculated by MDRD equation; GFR-VIM = variability independent of mean of eGFR; HR = hazard ratio, adjusted by Model 2 (age, sex, smoking status, alcohol consumption, regular physical activity, low income level, body-mass index, hypertension, diabetes, and baseline eGFR); IR = incidence rate in 1,000 person-years. *Each subgroup represents the 4th quartile of GFR-VIM with a suggested condition, whereas the corresponding lower three quartiles served as a reference. †Individuals with decreased or increased eGFR…

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  Figure 4. The flow chart of the study population. A total of 3,551,249 individuals were analyzed in the study. This population then categorized into the four groups by quartiles of GFR-VIM. Abbreviation: eGFR = estimated glomerular filtration rate calculated by MDRD equation; GFR-VIM = variability independent of mean of eGFR; IDMS = isotope dilution mass spectrometry; NHIS = national health insurance service.