{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:36:51Z","timestamp":1787960211968,"version":"build-2784847793"},"reference-count":37,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T00:00:00Z","timestamp":1680220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: Atrial fibrillation (AF) is associated with the development and progression of chronic kidney disease (CKD). This study evaluated the impact of long-term rhythm outcome after catheter ablation (CA) of AF on renal function. Methods and results: The study group included 169 consecutive patients (the mean age was 59.6 \u00b1 10.1 years, 61.5% were males) who underwent their first CA of AF. Renal function was assessed by eGFR (using the CKD-EPI and MDRD formulas), and by creatinine clearance (using the Cockcroft\u2013Gault formula) in each patient before and 5 years after index CA procedure. During the 5-year follow-up after CA, the late recurrence of atrial arrhythmia (LRAA) was documented in 62 patients (36.7%). The mean eGFR, regardless of which formula was used, significantly decreased at 5 years following CA in patients with LRAA (all p &lt; 0.05). In the arrhythmia-free patients, the mean eGFR at 5 years post-CA remained stable (for the CKD-EPI formula: 78.7 \u00b1 17.3 vs. 79.4 \u00b1 17.4, p = 0.555) or even significantly improved (for the MDRD formula: 74.1 \u00b1 17.0 vs. 77.4 \u00b1 19.6, p = 0.029) compared with the baseline. In the multivariable analysis, the independent risk factors for rapid CKD progression (decline in eGFR &gt; 5 mL\/min\/1.73 m2 per year) were the post-ablation LRAA occurrence (hazard ratio 3.36 [95% CI: 1.25\u20139.06], p = 0.016), female sex (3.05 [1.13\u20138.20], p = 0.027), vitamin K antagonists (3.32 [1.28\u20138.58], p = 0.013), or mineralocorticoid receptor antagonists\u2019 use (3.28 [1.13\u20139.54], p = 0.029) after CA. Conclusions: LRAA after CA is associated with a significant decrease in eGFR, and it is an independent risk factor for rapid CKD progression. Conversely, eGFR in arrhythmia-free patients after CA remained stable or even improved significantly.<\/jats:p>","DOI":"10.3390\/jcdd10040151","type":"journal-article","created":{"date-parts":[[2023,3,31]],"date-time":"2023-03-31T10:19:33Z","timestamp":1680257973000},"page":"151","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Long-Term Renal Function after Catheter Ablation of Atrial Fibrillation"],"prefix":"10.3390","volume":"10","author":[{"given":"Vladan","family":"Kova\u010devi\u0107","sequence":"first","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9770-0999","authenticated-orcid":false,"given":"Milan M.","family":"Marinkovi\u0107","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandar","family":"Kocijan\u010di\u0107","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikola","family":"Isailovi\u0107","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jelena","family":"Simi\u0107","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miroslav","family":"Mihajlovi\u0107","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Vu\u010di\u0107evi\u0107","sequence":"additional","affiliation":[{"name":"Center for Anesthesiology, University Clinical Center of Serbia, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatjana S.","family":"Potpara","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neboj\u0161a M.","family":"Mujovi\u0107","sequence":"additional","affiliation":[{"name":"Cardiology Clinic, University Clinical Center of Serbia, 11000 Belgrade, Serbia"},{"name":"Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"Hindricks","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1038\/kisup.2012.64","article-title":"Chapter 1: Definition and classification of CKD","volume":"3","author":"Levin","year":"2013","journal-title":"Kidney Int. Suppl."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Major, R.W., Cheng, M.R.I., Grant, R.A., Shantikumar, S., Xu, G., Oozeerally, I., Brunskill, N.J., and Gray, L.J. (2018). Cardiovascular disease risk factors in chronic kidney disease: A systematic review and meta-analysis. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0192895"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1046","DOI":"10.1093\/cvr\/cvaa258","article-title":"Pathophysiology of atrial fibrillation and chronic kidney disease","volume":"117","author":"Ding","year":"2021","journal-title":"Cardiovasc. Res."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1161\/CIRCULATIONAHA.112.123992","article-title":"Incident atrial fibrillation and risk of end-stage renal disease in adults with chronic kidney disease","volume":"127","author":"Bansal","year":"2013","journal-title":"Circulation"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.2215\/CJN.04060318","article-title":"Incident Atrial Fibrillation and the Risk of Stroke in Adults with Chronic Kidney Disease: The Stockholm CREAtinine Measurements (SCREAM) Project","volume":"13","author":"Carrero","year":"2018","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.ijcard.2018.11.098","article-title":"Comparison of atrial fibrillation in CKD and non-CKD populations: A cross-sectional analysis from the Kailuan study","volume":"277","author":"Guo","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1161\/CIRCULATIONAHA.107.744466","article-title":"Metabolic syndrome and risk of development of atrial fibrillation: The Niigata preventive medicine study","volume":"117","author":"Watanabe","year":"2008","journal-title":"Circulation"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1093\/europace\/eux275","article-title":"2017 HRS\/EHRA\/ECAS\/APHRS\/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation: Executive summary","volume":"20","author":"Calkins","year":"2018","journal-title":"Europace"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1007\/s12325-017-0590-z","article-title":"Catheter Ablation of Atrial Fibrillation: An Overview for Clinicians","volume":"34","author":"Mujovic","year":"2017","journal-title":"Adv. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1111\/jce.13322","article-title":"Persistency of left atrial linear lesions after radiofrequency catheter ablation for atrial fibrillation: Data from an invasive follow-up electrophysiology study","volume":"28","author":"Mujovic","year":"2017","journal-title":"J. Cardiovasc. Electrophysiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3006","DOI":"10.1161\/01.CIR.0000103131.70301.4F","article-title":"Inflammation as a risk factor for atrial fibrillation","volume":"108","author":"Aviles","year":"2003","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1093\/eurheartj\/ehi668","article-title":"Role of angiotensin system and effects of its inhibition in atrial fibrillation: Clinical and experimental evidence","volume":"27","author":"Ehrlich","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1016\/j.hrthm.2009.12.009","article-title":"Role of inflammation and oxidative stress in atrial fibrillation","volume":"7","author":"Li","year":"2010","journal-title":"Heart Rhythm"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e013204","DOI":"10.1161\/JAHA.119.013204","article-title":"Five-Year Change in the Renal Function After Catheter Ablation of Atrial Fibrillation","volume":"8","author":"Park","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2816","DOI":"10.1093\/eurheartj\/ehab291","article-title":"Atrial fibrillation and kidney function: A bidirectional Mendelian randomization study","volume":"42","author":"Park","year":"2021","journal-title":"Eur. Heart J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1161\/CIRCULATIONAHA.111.047266","article-title":"Renal function after catheter ablation of atrial fibrillation","volume":"124","author":"Takahashi","year":"2011","journal-title":"Circulation"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Kawaji, T., Shizuta, S., Aizawa, T., Yamagami, S., Takeji, Y., Yoshikawa, Y., Kato, M., Yokomatsu, T., Miki, S., and Ono, K. (2020). Renal function and outcomes in atrial fibrillation patients after catheter ablation. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0241449"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.acvd.2019.02.006","article-title":"Renal function and outcomes after catheter ablation of patients with atrial fibrillation: The Guangzhou atrial fibrillation ablation registry","volume":"112","author":"Deng","year":"2019","journal-title":"Arch. Cardiovasc. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1136\/heartjnl-2014-306013","article-title":"Changes in renal function after catheter ablation of atrial fibrillation are associated with CHADS2 and CHA2DS2-VASc scores and arrhythmia recurrences","volume":"101","author":"Kornej","year":"2015","journal-title":"Heart"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1038\/kisup.2012.65","article-title":"Chapter 2: Definition, identification, and prediction of CKD progression","volume":"3","author":"Base","year":"2013","journal-title":"Kidney Int. Suppl."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1038\/sj.ki.5000058","article-title":"The progression of chronic kidney disease: A 10-year population-based study of the effects of gender and age","volume":"69","author":"Eriksen","year":"2006","journal-title":"Kidney Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2582","DOI":"10.1681\/ASN.2005121352","article-title":"Macroalbuminuria is a better risk marker than low estimated GFR to identify individuals at risk for accelerated GFR loss in population screening","volume":"17","author":"Halbesma","year":"2006","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1291\/hypres.31.433","article-title":"Slower decline of glomerular filtration rate in the Japanese general population: A longitudinal 10-year follow-up study","volume":"31","author":"Imai","year":"2008","journal-title":"Hypertens. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1053\/j.ajkd.2008.06.023","article-title":"Variability and risk factors for kidney disease progression and death following attainment of stage 4 CKD in a referred cohort","volume":"52","author":"Levin","year":"2008","journal-title":"Am. J. Kidney Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e006852","DOI":"10.1161\/CIRCOUTCOMES.120.006852","article-title":"Reclassification, Thromboembolic, and Major Bleeding Outcomes Using Different Estimates of Renal Function in Anticoagulated Patients With Atrial Fibrillation: Insights From the PREFER-in-AF and PREFER-in-AF Prolongation Registries","volume":"14","author":"Rohla","year":"2021","journal-title":"Circ. Cardiovasc. Qual. Outcomes"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1038\/nrneph.2017.181","article-title":"Sex and gender disparities in the epidemiology and outcomes of chronic kidney disease","volume":"14","author":"Carrero","year":"2018","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1038\/ki.2008.200","article-title":"Gender differences in predictors of the decline of renal function in the general population","volume":"74","author":"Halbesma","year":"2008","journal-title":"Kidney Int."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"2047","DOI":"10.1093\/ndt\/gfg317","article-title":"The rate of progression of renal disease may not be slower in women compared with men: A patient-level meta-analysis","volume":"18","author":"Jafar","year":"2003","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.kint.2019.02.030","article-title":"Mineralocorticoid receptor antagonists and kidney diseases: Pathophysiological basis","volume":"96","author":"Girerd","year":"2019","journal-title":"Kidney Int."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1160\/TH08-09-0611","article-title":"Relation of circulating Matrix Gla-Protein and anticoagulation status in patients with aortic valve calcification","volume":"101","author":"Koos","year":"2009","journal-title":"Thromb. Haemost."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1681\/ASN.2016060651","article-title":"Vitamin K-Dependent Carboxylation of Matrix Gla Protein Influences the Risk of Calciphylaxis","volume":"28","author":"Nigwekar","year":"2017","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.jcma.2017.08.021","article-title":"Warfarin accelerated vascular calcification and worsened cardiac dysfunction in remnant kidney mice","volume":"81","author":"Tsai","year":"2018","journal-title":"J. Chin. Med. Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1038\/ki.2011.44","article-title":"Warfarin-related nephropathy occurs in patients with and without chronic kidney disease and is associated with an increased mortality rate","volume":"80","author":"Brodsky","year":"2011","journal-title":"Kidney Int."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1093\/ckj\/sfu080","article-title":"Anticoagulation in chronic kidney disease patients-the practical aspects","volume":"7","author":"Hughes","year":"2014","journal-title":"Clin. Kidney J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1038\/nrneph.2018.19","article-title":"Use of oral anticoagulants in patients with atrial fibrillation and renal dysfunction","volume":"14","author":"Potpara","year":"2018","journal-title":"Nat. Rev. Nephrol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1297","DOI":"10.1016\/j.ijcard.2014.07.166","article-title":"Warfarin-related nephropathy: Prevalence, risk factors and prognosis","volume":"176","author":"Yang","year":"2014","journal-title":"Int. J. Cardiol."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/10\/4\/151\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:07:50Z","timestamp":1760123270000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/10\/4\/151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,31]]},"references-count":37,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["jcdd10040151"],"URL":"https:\/\/doi.org\/10.3390\/jcdd10040151","relation":{},"ISSN":["2308-3425"],"issn-type":[{"value":"2308-3425","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,31]]}}}