Fibrilación Auricular y Enfermedad Renal Crónica: Un Análisis Integral de la Interacción y su Relevancia en la Práctica Clínica
DOI:
https://doi.org/10.61154/rucs.v8i1.3625Palabras clave:
cardiopatía, fibrilación atrial, hipertensión arterial, enfermedad renal crónica, sistema renina angiotensina aldosteronaResumen
La enfermedad renal crónica (ERC) se caracteriza por alteraciones prolongadas en la estructura o función renal, con implicaciones graves como hipertensión, enfermedades cardíacas y neurológicas. La fibrilación auricular (FA) es una arritmia cardiaca que muestra una relación compleja con la ERC: la presencia de ERC aumenta el riesgo de desarrollar FA, y viceversa. Varios factores, como la inflamación, el sistema renina-angiotensina-aldosterona, la anemia y las alteraciones electrolíticas contribuyen a esta relación. Ambas condiciones incrementan el riesgo de accidentes cerebrovasculares y mortalidad. El manejo adecuado implica considerar la complejidad de estas conexiones para reducir los riesgos asociados y mejorar el pronóstico de los pacientes.Descargas
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Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C, et al. Guía ESC 2020 sobre el diagnóstico y tratamiento de la fibrilación auricular, desarrollada en colaboración de la European Association of Cardio-Thoracic Surgery (EACTS). Rev Esp Cardiol [Internet]. 2021 May;74(5):437.e1-437.e116. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0300893220306953
García-Maset R, Bover J, Segura de la Morena J, Goicoechea Diezhandino M, Cebollada del Hoyo J, Escalada San Martín J, et al. Documento de información y consenso para la detección y manejo de la enfermedad renal crónica. Nefrología [Internet]. 2022 May;42(3):233–64. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0211699521001612
Ding WY, Gupta D, Wong CF, Lip GYH. Pathophysiology of atrial fibrillation and chronic kidney disease. Cardiovasc Res [Internet]. 2021 Mar 21;117(4):1046–59. Available from: https://academic.oup.com/cardiovascres/article/117/4/1046/5900260
Kim S, Jeong Y, Kim YL, Kang M, Kang E, Ryu H, et al. Association of Chronic Kidney Disease With Atrial Fibrillation in the General Adult Population: A Nationwide Population‐Based Study. J Am Heart Assoc [Internet]. 2023 Apr 18;12(8). Available from: https://www.ahajournals.org/doi/10.1161/JAHA.122.028496
Gadde S, Kalluru R, Cherukuri SP, Chikatimalla R, Dasaradhan T, Koneti J. Atrial Fibrillation in Chronic Kidney Disease: An Overview. Cureus [Internet]. 2022 Aug 7;14(8). Available from: https://www.cureus.com/articles/107776-atrial-fibrillation-in-chronic-kidney-disease-an-overview
Rehm M, Rothenbacher D, Iacoviello L, Costanzo S, Tunstall‐Pedoe H, Fitton CA, et al. Chronic kidney disease and risk of atrial fibrillation and heart failure in general population‐based cohorts: the BiomarCaRE project. ESC Heart Fail [Internet]. 2022 Feb 26;9(1):57–65. Available from: https://onlinelibrary.wiley.com/doi/10.1002/ehf2.13699
Potpara TS, Ferro C, Lip GYH, Dan GA, Lenarczyk R, Mallamaci F, et al. Management of atrial fibrillation in patients with chronic kidney disease in clinical practice: a joint European Heart Rhythm Association (EHRA) and European Renal Association/European Dialysis and Transplantation Association (ERA/EDTA) physician-based survey. EP Europace [Internet]. 2020 Mar 1;22(3):496–505. Available from: https://academic.oup.com/europace/article/22/3/496/5712974
Elliott AD, Middeldorp ME, Van Gelder IC, Albert CM, Sanders P. Epidemiology and modifiable risk factors for atrial fibrillation. Nature Reviews Cardiology 2023 20:6 [Internet]. 2023 Jan 4 [cited 2023 Oct 26];20(6):404–17. Available from: https://www.nature.com/articles/s41569-022-00820-8
Kovesdy CP. Epidemiology of chronic kidney disease: an update 2022. Kidney Int Suppl (2011) [Internet]. 2022 Apr;12(1):7–11. Available from: https://linkinghub.elsevier.com/retrieve/pii/S2157171621000666
Vélez-Victoria J. Situación actual de la enfermedad renal en Latinoamérica y los desafíos para el cirujano vascular. Revista Mexicana de Angiolog�a [Internet]. 2023 Feb 22;51(1). Available from: https://www.rmangiologia.com/frame_esp.php?id=103
Gahona Villegas JR, Reyes Jurado P, Prado Cabrera AS, Meza Rodríguez KM, Benítez Kellendonk CH. Descripción y análisis de la tasa de incidencia y prevalencia de pacientes en terapia de reemplazo renal en Ecuador. Metro Ciencia [Internet]. 2023 Jun 30;30(2):35–40. Available from: https://revistametrociencia.com.ec/index.php/revista/article/view/563
Kornej J, Börschel CS, Benjamin EJ, Schnabel RB. Epidemiology of Atrial Fibrillation in the 21st Century. Circ Res [Internet]. 2020 Jun 19;127(1):4–20. Available from: https://www.ahajournals.org/doi/10.1161/CIRCRESAHA.120.316340
García-Peña ÁA, Ospina-Buitrago DA, Rico-Mendoza J del P, Fernández-Ávila DG, Muñoz-Velandia ÓM, Suárez F. Prevalencia de fibrilación auricular en Colombia según información del Sistema Integral de Información de la Protección Social (SISPRO). Revista Colombiana de Cardiología [Internet]. 2022 May 27;29(2). Available from: https://www.rccardiologia.com/frame_esp.php?id=154
Vallianou NG, Mitesh S, Gkogkou A, Geladari E. Chronic Kidney Disease and Cardiovascular Disease: Is there Any Relationship? Curr Cardiol Rev [Internet]. 2018 Dec 11;15(1):55–63. Available from: http://www.eurekaselect.com/163687/article
Vaidya SR, Aeddula NR. Chronic Kidney Disease [Internet]. StatPearls. 2023. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25018975
Sellarés Víctor, Rodríguez Luis. ENFERMEDAD RENAL CRÓNICA [Internet]. [cited 2023 Dec 6]. Available from: https://www.nefrologiaaldia.org/136
Nesheiwat Z, Goyal A, Jagtap M. Atrial Fibrillation [Internet]. StatPearls. 2023. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12860883
Ocak G, Khairoun M, Khairoun O, Bos WJW, Fu EL, Cramer MJ, et al. Chronic kidney disease and atrial fibrillation: A dangerous combination. Wu PH, editor. PLoS One [Internet]. 2022 Apr 7;17(4):e0266046. Available from: https://dx.plos.org/10.1371/journal.pone.0266046
Nso N, Bookani KR, Metzl M, Radparvar F. Role of inflammation in atrial fibrillation: A comprehensive review of current knowledge. J Arrhythm [Internet]. 2021 Feb 23;37(1):1–10. Available from: https://onlinelibrary.wiley.com/doi/10.1002/joa3.12473
Harada M, Nattel S. Implications of Inflammation and Fibrosis in Atrial Fibrillation Pathophysiology. Card Electrophysiol Clin. 2021 Mar;13(1):25–35.
Fountain JH, Kaur J, Lappin SL. Physiology, Renin Angiotensin System [Internet]. StatPearls. Treasure Island (FL); 2024. Available from: http://www.ncbi.nlm.nih.gov/pubmed/33875979
Vargas Vargas RA, Varela Millán JM, Fajardo Bonilla E. Renin-angiotensin system: Basic and clinical aspects-A general perspective. Endocrinol Diabetes Nutr. 2022 Jan;69(1):52–62.
Sandefur CC, Jialal I. Atrial Natriuretic Peptide [Internet]. StatPearls. 2024. Available from: http://www.ncbi.nlm.nih.gov/pubmed/29859763
Pandey KN. Molecular Signaling Mechanisms and Function of Natriuretic Peptide Receptor-A in the Pathophysiology of Cardiovascular Homeostasis. Front Physiol [Internet]. 2021 Aug 19;12. Available from: https://www.frontiersin.org/articles/10.3389/fphys.2021.693099/full
El Chamieh C, Liabeuf S, Massy Z. Uremic Toxins and Cardiovascular Risk in Chronic Kidney Disease: What Have We Learned Recently beyond the Past Findings? Toxins (Basel) [Internet]. 2022 Apr 14;14(4):280. Available from: https://www.mdpi.com/2072-6651/14/4/280
Kaneko T, Kodani E, Fujii H, Asai R, Seki M, Nakazato R, et al. Anemia and atrial fibrillation as independent risk factors for new-onset chronic kidney disease: the TAMA-MED Project—CKD and AF. Clin Kidney J [Internet]. 2021 Sep 30;14(10):2221–6. Available from: https://academic.oup.com/ckj/article/14/10/2221/6118195
Shaikh H, Hashmi MF, Aeddula NR. Anemia of Chronic Renal Disease [Internet]. StatPearls. 2024. Available from: http://www.ncbi.nlm.nih.gov/pubmed/4975372
Martens P. The Effect of Iron Deficiency on Cardiac Function and Structure in Heart Failure with Reduced Ejection Fraction. Card Fail Rev [Internet]. 2022 Mar 16;8:e06. Available from: https://www.cfrjournal.com/articleindex/cfr.2021.26
Hanna-Rivero N, Tu SJ, Elliott AD, Pitman BM, Gallagher C, Lau DH, et al. Anemia and iron deficiency in patients with atrial fibrillation. BMC Cardiovasc Disord [Internet]. 2022 May 4;22(1):204. Available from: https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-022-02633-6
Bikbov B, Purcell CA, Levey AS, Smith M, Abdoli A, Abebe M, et al. Global, regional, and national burden of chronic kidney disease, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet [Internet]. 2020 Feb;395(10225):709–33. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0140673620300453
Chen TH, Chu YC, Ou SM, Tarng DC. Associations of atrial fibrillation with renal function decline in patients with chronic kidney disease. Heart [Internet]. 2022 Mar;108(6):438–44. Available from: https://heart.bmj.com/lookup/doi/10.1136/heartjnl-2021-319297
Gupta D, Rienstra M, van Gelder IC, Fauchier L. Atrial fibrillation: better symptom control with rate and rhythm management. The Lancet Regional Health - Europe [Internet]. 2024 Feb;37:100801. Available from: https://linkinghub.elsevier.com/retrieve/pii/S266677622300220X
Yang LJ, Hsu SM, Wu PH, Lin MY, Huang TH, Lin YT, et al. Association of digoxin with mortality in patients with advanced chronic kidney disease: A population-based cohort study. Brunner-La Rocca HP, editor. PLoS One [Internet]. 2021 Jan 15;16(1):e0245620. Available from: https://dx.plos.org/10.1371/journal.pone.0245620
Sidhu B, Mavilakandy A, Hull KL, Koev I, Vali Z, Burton JO, et al. Atrial Fibrillation and Chronic Kidney Disease: Aetiology and Management. Rev Cardiovasc Med [Internet]. 2024 Apr 9;25(4):143. Available from: https://www.imrpress.com/journal/RCM/25/4/10.31083/j.rcm2504143
Gupta D, Rienstra M, van Gelder IC, Fauchier L. Atrial fibrillation: better symptom control with rate and rhythm management. The Lancet Regional Health - Europe [Internet]. 2024 Feb;37:100801. Available from: https://linkinghub.elsevier.com/retrieve/pii/S266677622300220X
Kozieł M, Simovic S, Pavlovic N, Nedeljkovic M, Kocijancic A, Paparisto V, et al. Treatment implications of renal disease in patients with atrial fibrillation: The BALKAN‐AF survey. J Arrhythm [Internet]. 2020 Oct 19;36(5):863–73. Available from: https://onlinelibrary.wiley.com/doi/10.1002/joa3.12404
Basnet A, Naeem A, Sharma NR, Lamichhane S, Kansakar S, Gautam S, et al. Atrial Fibrillation Ablation in Patients With Chronic Kidney Disease: A Review of Literature. Cureus [Internet]. 2023 Oct 5; Available from: https://www.cureus.com/articles/185652-atrial-fibrillation-ablation-in-patients-with-chronic-kidney-disease-a-review-of-literature
Potpara TS, Ferro C, Lip GYH, Dan GA, Lenarczyk R, Mallamaci F, et al. Management of atrial fibrillation in patients with chronic kidney disease in clinical practice: a joint European Heart Rhythm Association (EHRA) and European Renal Association/European Dialysis and Transplantation Association (ERA/EDTA) physician-based survey. EP Europace [Internet]. 2020 Mar 1;22(3):496–505. Available from: https://academic.oup.com/europace/article/22/3/496/5712974
January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society in Collaboration With the Society of Thoracic Surgeons. Circulation [Internet]. 2019 Jul 9;140(2). Available from: https://www.ahajournals.org/doi/10.1161/CIR.0000000000000665
Steffel J, Collins R, Antz M, Cornu P, Desteghe L, Haeusler KG, et al. 2021 European Heart Rhythm Association Practical Guide on the Use of Non-Vitamin K Antagonist Oral Anticoagulants in Patients with Atrial Fibrillation. EP Europace [Internet]. 2021 Oct 9;23(10):1612–76. Available from: https://academic.oup.com/europace/article/23/10/1612/6247378
Matusi PT, Heleniak Z, Undas A. Anticoagulant Treatment in Patients with Atrial Fibrillation and Chronic Kidney Disease: Practical Issues. The Anatolian Journal of Cardiology [Internet]. 2022 Nov 28;26(12):857–63. Available from: https://anatoljcardiol.com/jvi.aspx?un=AJC-36602
Yao X, Inselman JW, Ross JS, Izem R, Graham DJ, Martin DB, et al. Comparative Effectiveness and Safety of Oral Anticoagulants Across Kidney Function in Patients With Atrial Fibrillation. Circ Cardiovasc Qual Outcomes. 2020 Oct;13(10).
Belley-Cote EP, Eikelboom JW. Anticoagulation for Stroke Prevention in Patients With Atrial Fibrillation and End-Stage Renal Disease—First, Do No Harm. JAMA Netw Open. 2020 Apr 6;3(4):e202237.
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