Key result
Higher KDIGO CKD risk linked to ~4-fold higher post-ablation HF hospitalization rate.
Why the study?
In patients undergoing AF ablation, the distribution of CKD across KDIGO risk categories and its prognostic value remained unclear.
Cohort (n=942)
KDIGO CKD risk categories effectively stratify long-term heart failure hospitalization risk following atrial fibrillation ablation, highlighting a sharp risk increase at the High-risk threshold and substantial underuse of SGLT2 inhibitors.
May refine post-AF ablation HF risk assessment via KDIGO categories; extends CKM observational data but does not yet support practice change.
Background Chronic kidney disease (CKD) is a key component of the cardiovascular–kidney–metabolic (CKM) framework. However, in patients undergoing atrial fibrillation (AF) ablation, the distribution of CKD across Kidney Disease: Improving Global Outcomes (KDIGO) risk categories and its prognostic value remain unclear. Methods Patients undergoing AF ablation with preprocedural urinalysis were studied. Patients were classified into KDIGO CKD risk categories (Low, Moderate, High, Very high) using the estimated glomerular filtration rate and predicted urine albumin–creatinine ratio derived from dipstick proteinuria. We compared post-discharge heart failure (HF) hospitalization incidence across risk categories and assessed CKM multimorbidity (all three components present) and the use of kidney-protective therapies. Results Among 942 patients, 505, 277, 118, and 42 were classified as Low, Moderate, High, and Very high risk, respectively; 46.3% met the KDIGO definition of CKD (≥Moderate). Over a median follow-up of 5.1 years (interquartile range, 3.1–7.1), 72 patients (7.6%) were hospitalized for HF. HF hospitalization incidence increased across CKD risk categories (p<0.001), with a marked rise from Moderate to High risk (1.90 [95% confidence interval, 1.26–2.74] vs 7.74 [5.66–10.30] events per 100 person-years). CKM multimorbidity occurred in 42% of the High and 67% of Very high risk patients. The use of sodium–glucose cotransporter 2 inhibitors remained low in the Moderate (19%) and High (27%) groups. Conclusion KDIGO CKD risk categories stratified long-term HF hospitalization risk after AF ablation, with a sharp increase at High risk. Underuse of kidney-protective therapies was observed in the Moderate-to-High risk groups.
No takes yet. Share an insight, caveat, or question.
Ishiguchi et al. (2026) conducted a cohort in Atrial fibrillation undergoing catheter ablation (n=942). KDIGO CKD risk categories (High vs Moderate risk, alongside Low and Very high risk) vs. Moderate KDIGO CKD risk category (and overall lower risk categories) was evaluated on Post-discharge heart failure (HF) hospitalization incidence (events per 100 person-years) (p=<0.001). Higher KDIGO CKD risk categories stratified post-ablation HF hospitalization risk (p<0.001), rising from 1.90 to 7.74 events per 100 person-years between Moderate and High risk.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: