Introduction: Emerging data suggest that cardioversion for atrial fibrillation (AF) may be associated with acute kidney injury (AKI). However, limited data are available regarding the incidence and risk factors for AKI after direct current cardioversion (DCCV) of AF. Methods: All patients undergoing DCCV at Mayo Clinic between 2001 and 2012 for AF were prospectively enrolled in a database. All patients with serum creatinine (SCR) values pre- and post-cardioversion were reviewed for AKI, defined as a ≥25% decline in eGFR (estimated glomerular filtration rate) from baseline value within 7 days of the DCCV. Results: Of the 6,427 eligible patients, 1,256 (19.5%) patients had pre- and post-DCCV SCR available and formed the cohort under study. The mean age was 70.4 (SD 11.7) years, and 67.3% were male. During the study period, 131 (10.4%) patients suffered from AKI following DCCV. AKI was independently associated with inpatient status (OR 26.79; 95% CI 3.69–194.52), CHA₂DS₂-VASc score (OR 1.25; 95% CI 1.11–1.41), prior use of diuretics (OR 1.59; 95% CI 1.03–2.46), and absence of CKD (OR 1.61; 95% CI 1.04–2.49), and was independent of the success of the DCCV. None of the patients required acute dialysis during the study outcome period. Conclusion: AKI following DCCV of AF is common, self-limited, and without the need for replacement therapies.
Cardiorenal Med

中文翻译：

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心房颤动直流电复律后的肾功能障碍：发病率和危险因素

简介：新数据表明，心房颤动 (AF) 的心脏复律可能与急性肾损伤 (AKI) 相关。然而，关于 AF 直流电复律 (DCCV) 后 AKI 的发生率和危险因素的数据有限。方法：所有在 2001 年至 2012 年期间在梅奥诊所接受 DCCV 的 AF 患者均被前瞻性纳入数据库。所有在心脏复律前后血清肌酐 (SCR) 值的患者都接受了 AKI 评估，定义为在 DCCV 后 7 天内 eGFR（估计肾小球滤过率）从基线值下降 ≥25%。结果：在 6,427 名符合条件的患者中，1,256 名 (19.5%) 名患者有 DCCV 前后可用的 SCR，并形成了正在研究的队列。平均年龄为 70.4 (SD 11.7) 岁，67.3% 为男性。在研究期间，131 名 (10.4%) 患者在 DCCV 后出现 AKI。AKI 与住院状态（OR 26.79；95% CI 3.69–194.52）、CHA ₂ DS ₂ -VASc 评分（OR 1.25；95% CI 1.11–1.41）、先前使用利尿剂（OR 1.59；95% CI 1.03）独立相关–2.46)，没有 CKD (OR 1.61；95% CI 1.04–2.49)，并且独立于 DCCV 的成功。在研究结果期间，没有患者需要急性透析。结论： AF DCCV 后 AKI 很常见，具有自限性，无需替代治疗。
心肾医学