Disentangling the association between kidney function and atrial fibrillation: a bidirectional Mendelian randomization study

Sven Geurts, Anna C. van der Burgh, Maxime M. Bos, M. Arfan Ikram, Bruno H.C. Stricker, Jaap W. Deckers, Ewout J. Hoorn, Layal Chaker, Maryam Kavousi*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

14 Citations (Scopus)
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Abstract

Background: The potential bidirectional causal association between kidney function and atrial fibrillation (AF) remains unclear. Methods: We conducted a bidirectional two-sample Mendelian randomization (MR) analysis. From multiple genome-wide association studies (GWAS), we retrieved genetic variants associated with kidney function (estimated glomerular filtration rate based on creatinine (eGFRcreat), blood urea nitrogen (BUN), chronic kidney disease (CKD stage ≥G3): n = 1,045,620, eGFR based on cystatin C: n = 24,063-32,861, urine albumin-tocreatinine ratio (UACR), and microalbuminuria: n = 564,257), and AF (n = 1,030,836). The inverse-variance weighted method was used as our main analysis. Results: MR analyses supported a causal effect of CKD (n = 9 SNPs, odds ratio (OR): 1.10, 95% confidence interval (CI): 1.04–1.17, p-value = 1.97 × 10− 03), and microalbuminuria (n = 5 SNPs, OR: 1.26, 95% CI: 1.10–1.46, pvalue = 1.38 × 10− 03) on AF risk. We also observed a causal effect of AF on eGFRcreat (n = 97 SNPs, OR: 1.00, 95% CI: 1.00–1.00, p-value = 6.78 × 10− 03), CKD (n = 107 SNPs, OR: 1.06, 95% CI: 1.03–1.09, p-value = 2.97 × 10− 04), microalbuminuria (n = 83 SNPs, OR: 1.07, 95% CI: 1.04–1.09, p-value = 2.49 × 10− 08), and a suggestive causal effect on eGFRcys (n = 103 SNPs, OR: 0.99, 95% CI: 0.99–1.00, p-value = 4.61 × 10− 02). Sensitivity analyses, including weighted median estimator, MR-Egger, the MR pleiotropy residual sum and outlier test, and excluding genetic variants associated with possible confounders and/or horizontal mediators (myocardial infarction/coronary artery disease, heart failure) indicated that these findings were robust. Conclusions: Our results supported a bidirectional causal association between kidney function and AF. The shared genetic architecture between kidney dysfunction and AF might represent potential important therapeutic targets to prevent both conditions in the general population.
Original languageEnglish
Pages (from-to)15-22
Number of pages8
JournalInternational Journal of Cardiology
Volume355
DOIs
Publication statusPublished - 15 May 2022

Bibliographical note

Funding Information:
This study is supported by the Gender and prevention grant ( 555003017 ) from ZonMw .

Publisher Copyright: © 2022 The Author(s)

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