Atrial fibrillation and diabetic nephropathy

Evidence suggests that people with diabetes have a higher incidence of atrial fibrillation (AF) than the general population. It is also common knowledge that people with diabetes are at higher risk of developing diabetic nephropathy. A higher risk of atrial fibrillation has been suggested in specific reviews and studies on people with diabetic nephropathy, but no definitive evidence exists at this time. To pool data from multiple studies to determine if diabetic nephropathy and AF are related. Research articles published between January 1995 and November 2020 were analyzed. Studies were restricted based on their ability to meet certain quality assessment criteria, such as well-defined comparison groups, measuring the same outcome in all groups, accounting for any confounding factors and monitoring patients for at least 80% of the time. Two separate reviewers conducted the searches, developed their methodologies and conducted the reviews. Cochrane’s RevMan 5.3 processed the data to provide a summary odds ratio and a forest plot. Only 4 studies met the inclusion criteria for this meta-analysis (total number of study participants: 307,330, patients with diabetic nephropathy: 22,855). About 2 of these studies were cross-sectional retrospectives, while the other 2 were prospective cohort studies and case-control studies. About 3 studies (2 retrospective cross-sectional studies and 1 case-control study) reported odds ratios as effect size, while the 1 cohort study reported hazard ratios. Therefore, the cohort study was ignored throughout the meta-analysis. The present analysis could not find statistical significance for the summary odds ratio of 1.32 (0.80-2.18). The summary estimate was biased towards zero due to substantial variability between the included studies and their relatively small sample sizes. Therefore, the current meta-analysis has not established a link between atrial fibrillation and diabetic nephropathy. However, further large-scale research is needed to strengthen existing data.

Source: journals.lww.com/jfmpc/Fulltext/2022/07000/Association_of_atrial_fibrillation_with_diabetic.79.aspx

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