Atrial fibrillation acts as a causal risk factor for kidney function impairment, whereas kidney function has no identified causal effect on atrial fibrillation.
Does atrial fibrillation causally affect kidney function, and does kidney function causally affect atrial fibrillation?
This Mendelian randomization study provides genetic evidence that atrial fibrillation causally contributes to kidney function impairment, highlighting the importance of renal monitoring in patients with atrial fibrillation.
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AIMS: The aim of this study was to investigate the causal effects between atrial fibrillation (AF) and kidney function. METHODS AND RESULTS: We performed a bidirectional summary-level Mendelian randomization (MR) analysis implementing the results from a large-scale genome-wide association study for estimated glomerular filtration rate (eGFR) by the CKDGen (N = 765 348) and AF (N = 588 190) to identify genetic instruments. The inverse variance weighted method was the main MR method used. For replication, an allele score-based MR was performed by individual-level data within a UK Biobank cohort of white British ancestry individuals (N = 337 138). A genetic predisposition to AF was significantly associated with decreased eGFR for log-eGFR, beta -0.003 (standard error, 0.0005), P < 0.001 and increased risk of chronic kidney disease beta 0.059 (0.0126), P < 0.001. The significance remained in MR sensitivity analyses and the causal estimates were consistent when we limited the analysis to individuals of European ancestry. Genetically predicted eGFR did not show a significant association with the risk of AF beta -0.366 (0.275), P = 0.183. The results were similar in allele score-based MR, as allele score for AF was significantly associated with reduced eGFR for continuous eGFR, beta -0.079 (0.021), P < 0.001, but allele score for eGFR did not show a significant association with risk of AF beta -0.005 (0.008), P = 0.530. CONCLUSIONS: Our study supports that AF is a causal risk factor for kidney function impairment. However, an effect of kidney function on AF was not identified in this study.
Park et al. (Tue,) reported a other. Atrial fibrillation acts as a causal risk factor for kidney function impairment, whereas kidney function has no identified causal effect on atrial fibrillation.