{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:18:22Z","timestamp":1787836702308,"version":"build-2784847793"},"reference-count":91,"publisher":"Ovid Technologies (Wolters Kluwer Health)","funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["CJASN"],"abstract":"<jats:p>\n                    Atrial fibrillation (AF) is the most common sustained arrhythmia, with a prevalence and incidence significantly higher in adults with CKD compared with the general population. This risk increases with reduced kidney function, affecting up to 25% of all patients with CKD and 30% of those on receiving chronic dialysis. AF is associated with increased morbidity and mortality, including higher risks of stroke, heart failure, myocardial dysfunction, and progression to kidney failure. The bidirectional relationship between AF and CKD is driven by a convergence of traditional risk factors\u2014such as hypertension and diabetes\u2014and CKD-specific abnormalities. Key pathophysiologic mechanisms include systemic inflammation, oxidative stress, autonomic dysfunction, and disordered mineral metabolism. These factors promote structural remodeling, atrial fibrosis, and electrical instability, creating a highly arrhythmogenic substrate. Treatment options for AF include anticoagulation, rate and rhythm control medications, other cardiovascular therapies (\n                    <jats:italic toggle=\"yes\">e.g<\/jats:italic>\n                    ., sodium glucose cotransporter 2 inhibitors), and procedures aimed at normalizing rhythm and reducing stroke risk. Patients with CKD are often undertreated with AF medications and procedures, in part because of lack of robust randomized clinical trial data on efficacy and safety, particularly with advanced CKD. This narrative review summarizes key literature on the epidemiology, risk factors, mechanisms and treatment of AF in adults with CKD, and highlights critical areas for future research.\n                  <\/jats:p>","DOI":"10.2215\/cjn.0000001159","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T18:01:37Z","timestamp":1782237697000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Atrial Fibrillation and Stroke Prevention and Management in CKD"],"prefix":"10.2215","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9583-8628","authenticated-orcid":false,"given":"Nisha","family":"Bansal","sequence":"first","affiliation":[{"name":"Division of Nephrology, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7695-3583","authenticated-orcid":false,"given":"David M.","family":"Charytan","sequence":"additional","affiliation":[{"name":"Nephrology Division, NYU Grossman, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3398-3114","authenticated-orcid":false,"given":"Amit X.","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Medicine, Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada"},{"name":"London Health Sciences Centre Research Institute, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel E.","family":"Singer","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Mass General Brigham Healthcare, Boston, Massachusetts"},{"name":"Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5632-8150","authenticated-orcid":false,"given":"Elsayed Z.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9146-2344","authenticated-orcid":false,"given":"Manish M.","family":"Sood","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, The Ottawa Hospital and The Ottawa Hospital Research Institute, Ottawa, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5272-425X","authenticated-orcid":false,"given":"Wolfgang C.","family":"Winkelmayer","sequence":"additional","affiliation":[{"name":"Selzman Institute for Kidney Health and Section of Nephrology, Baylor College of Medicine, Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9109-0811","authenticated-orcid":false,"given":"Alan S.","family":"Go","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland, California"},{"name":"Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"issue":"1","key":"B1-20260811","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.gheart.2014.01.004","article-title":"Global burden of atrial fibrillation in developed and developing nations","volume":"9","author":"Chugh","year":"2014","journal-title":"Glob Heart."},{"issue":"16","key":"B2-20260811","doi-asserted-by":"crossref","first-page":"1501","DOI":"10.1016\/j.jacc.2024.07.014","article-title":"Minimum 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