American journal of nephrology
July 2, 2026 · via Europe PMC
Metabolic Syndrome and Risk of Atrial Fibrillation in Chronic Kidney Disease.
Ravi KS, Mc Causland FR.
AI summary — for doctors, generated from the abstract only
In the CRIC cohort, metabolic syndrome, especially hypertension and visceral adiposity, was independently associated with higher risk of AF hospitalization in CKD.
What was studied
A prospective cohort analysis of 4,641 CRIC participants with CKD and no baseline AF, followed a mean 9.3 years for AF hospitalization.
Key findings
- 13% (616) hospitalized with AF
- Metabolic syndrome score: aHR 1.16 per unit (95% CI 1.08-1.24)
- Elevated waist circumference aHR 1.29 and hypertension aHR 1.61 independently associated
- Waist-to-height ratio aHR 1.23 per 0.1 and fat mass index aHR 1.22 per 5 kg/m2
Clinical relevance
This suggests visceral adiposity and hypertension may be useful markers of AF risk in CKD, raising the question of whether reducing visceral fat could mitigate it.
Who should care
Limitations
Observational design; AF captured only via hospitalization, likely missing outpatient AF.
In CKD, belly fat and hypertension are linked to a higher risk of atrial fibrillation.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Introduction
Metabolic syndrome is a potent risk factor for adverse cardiovascular outcomes including atrial fibrillation (AF). Although metabolic syndrome is common among patients with chronic kidney disease (CKD), its association with AF remains unclear.
Methods
We analyzed 4,641 participants in the Chronic Renal Insufficiency Cohort (CRIC) without baseline AF. Cox regression models evaluated the association of a metabolic syndrome score (Adult Treatment Panel III criteria), its components (hypertension, diabetes, waist circumference, elevated triglycerides, low HDL), and markers of visceral adiposity (waist-to-height ratio and fat mass index) with time to hospitalization with AF. The main model adjusted for demographics, stroke, lifestyle factors (smoking, alcohol use), and whether participants had ever been seen by a nephrologist (as a marker of healthcare utilization). An exploratory model additionally adjusted for laboratory parameters (eGFR, proteinuria, hemoglobin, albumin, and electrolytes), other cardiovascular comorbidities, and medications.
Results
The mean age of the participants was 59 ± 11 years, and 44% were female and 42% were black. Over a mean follow-up of 9.3 years, 616 (13%) were hospitalized with AF. Higher metabolic syndrome score was associated with hospitalization with AF (adjusted hazard ratio (aHR) per unit 1.16; 95% CI 1.08, 1.24). Elevated waist circumference and hypertension were the most consistently associated individual components, remaining independently associated with hospitalization with AF across all models including with concomitant adjustment for the remaining metabolic syndrome components (aHR 1.29; 95% CI 1.05, 1.60 and aHR 1.61; 95% CI 1.09, 2.39, respectively). The waist-to-height ratio and fat mass index were also associated with hospitalization with AF in the main adjusted model (aHR per 0.1 unit, 1.23; 95% CI, 1.14, 1.34 and aHR per 5 kg/m2, 1.22; 95% CI, 1.12, 1.34, respectively).
Conclusion
Among adults with CKD and no prior AF, hypertension and anthropometric markers of visceral adiposity are independently associated with a higher risk of hospitalization with AF. Future studies should explore mechanisms linking body composition to arrhythmia in CKD and whether reducing visceral adiposity could mitigate this risk.
DOI
10.1159/000553385
PMID
42391142
PMCID
PMC13383851
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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