Clinical nephrologyClinical nephrologyКлиническая нефрология2075-35942414-9322Bionika Media69965810.18565/nephrology.2025.4.76-80Literature ReviewsОбзоры литературыReview ArticleMolecular and physiological bases of atrial fibrillation in chronic kidney diseaseМолекулярные и физиологические основы фибрилляции предсердий при хронической болезни почекhttps://orcid.org/0000-0002-7314-0309IgamberdievaRanokhon Sh.ИгамбердиеваРанохон Шухратходжаевна
Uzbekistan

Cand.Sci. (Med.), Teaching Assistant, Department of Internal Medicine, Nephrology and Hemodialysis

к.м.н., ассистент, PhD кафедры «Внутренние болезни, нефрология и гемодиализа»

ranokhon.igamberdieva82@gmail.comhttps://orcid.org/0000-0002-9419-0831DaminovBotir T.ДаминовБотир Тургунпулатович
Uzbekistan

Dr.Sci. (Med.), Professor, Director, Professor at the Department of Internal Medicine, Nephrology and Hemodialysis

д.м.н., профессор, директор, профессор кафедры «Внутренние болезни, нефрология и гемодиализа»

daminovbotir@gmail.comTashkent State Medical UniversityТашкентский государственный медицинский университетRepublican Specialized Scientific and Practical Medical Center of Nephrology and Kidney TransplantationТашкентский государственный медицинский университетРеспубликанский специализированный научно-практический медицинский центр нефрологии и трансплантации почки2712202517476802612202526122025Copyright ©; 2025, Bionika MediaCopyright ©; 2025, ООО «Бионика Медиа»2025Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2075-3594/article/view/699658

Chronic kidney disease (CKD) is a progressive and most pressing problem of the healthcare system worldwide, since its prevalence reaches 15% among the world population. CKD increases mortality due to secondary complications, such as cardiovascular pathologies, including atrial fibrillation (AF). This review discusses well-known systemic factors linking CKD with pathogenetic and pathophysiological mechanisms of AF. The involvement of several inflammatory mediators in atrial arrhythmogenesis is emphasized, as well as the need for a deeper understanding of the molecular basis and high-quality clinical studies of the relationship between these comorbid conditions.

Хроническая болезнь почек (ХБП) является прогрессирующей и наиболее актуальной проблемой системы здравоохранения во всем мире, т.к. ее распространенность достигает 15% среди населения мира. ХБП увеличивает смертельные исходы за счет вторичных осложнений, таких как сердечно-сосудистые патологии, в т.ч. фибрилляция предсердий (ФП). В данном обзоре обсуждаются хорошо известные системные факторы, связывающие ХБП с патогенетическими и патофизиологическими механизмами ФП. Подчеркивается участие нескольких воспалительных медиаторов в предсердном аритмогенезе, а также необходимость более глубокого понимания молекулярной основы и проведения высококачественных клинических исследований связи данных коморбидных состояний.

chronic kidney diseaseatrial fibrillationinflammatory biomarkerselectrical and structural remodeling of cardiomyocytesхроническая болезнь почекфибрилляция предсердийвоспалительные биомаркерыэлектрическое и структурное ремоделирование кардиомиоцитовKovesdy C.P. Epidemiology of chronic kidney disease: an update 2022. Kidney Int. Suppl. (2011). 2022;12(1):7–11. Doi: 10.1016/j.kisu.2021.11.003. [Epub 2022 Mar 18, PMID: 35529086, PMCID: PMC9073222].Chen T.K., Knicely D.H., Grams M.E. Chronic Kidney Disease Diagnosis and Management: A Review. JAMA. 2019;322(13):1294–304. Doi: 10.1001/jama.2019.14745. [PMID: 31573641, PMCID: PMC7015670].Akoum N., Zelnick L.R., de Boer I.H. et al. Rates of Cardiac Rhythm Abnormalities in Patients with CKD and Diabetes. Clin. J. Am. Soc. Nephrol. 2019;14(4):549–56. Doi: 10.2215/CJN.09420818. [Epub 2019 Mar 19, PMID: 30890578, PMCID: PMC6450349].Ananthapanyasut W., Napan S., Rudolph E.H. et al. Prevalence of atrial fibrillation and its predictors in nondialysis patients with chronic kidney disease. Clin. J. Am. Soc. Nephrol. 2010;5(2):173–81. Doi: 10.2215/CJN.03170509. [Epub 2009 Dec 10, PMID: 20007681, PMCID: PMC2827597].Wetmore J.B., Mahnken J.D., Rigler S.K. et al. The prevalence of and factors associated with chronic atrial fibrillation in Medicare/Medicaid-eligible dialysis patients. Kidney Int. 2012;81(5):469–76. Doi: 10.1038/ki.2011.416. [Epub 2011 Dec 21, PMID: 22189842, PMCID: PMC3891593].Watanabe H., Watanabe T., Sasaki S. et al. Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am. Heart J. 2009;158(4):629–36. Doi: 10.1016/j.ahj.2009.06.031. [PMID: 19781424].Ha J.T., Freedman S.B., Kelly D.M. et al. Kidney Function, Albuminuria, and Risk of Incident Atrial Fibrillation: A Systematic Review and Meta-Analysis. Am. J. Kidney Dis. 2024;83(3):350–9.e1. Doi: 10.1053/j.ajkd.2023.07.023. [Epub 2023 Sep 29, PMID: 37777059].Massicotte-Azarniouch D., Kuwornu J.P., Carrero J.J. et al. Incident Atrial Fibrillation and the Risk of Congestive Heart Failure, Myocardial Infarction, End-Stage Kidney Disease, and Mortality Among Patients With a Decreased Estimated GFR. Am. J. Kidney Dis. 2018;71(2):191–9. Doi: 10.1053/j.ajkd.2017.08.016. [Epub 2017 Nov 16, PMID: 29153994].Hatamizadeh P., Fonarow G.C., Budoff M.J. et al. Cardiorenal syndrome: pathophysiology and potential targets for clinical management. Nat. Rev. Nephrol. 2013;9(2):99–111. Doi: 10.1038/nrneph.2012.279. [Epub 2012 Dec 18, PMID: 23247571].Zhao Y., Malik S., Budoff M.J. et al. Identification and Predictors for Cardiovascular Disease Risk Equivalents among Adults With Diabetes Mellitus. Diab. Care. 2021:dc210431. Doi: 10.2337/dc21-0431. [Epub ahead of print, PMID: 34380703].Heo N.J., Rhee S.Y., Waalen J., Steinhubl S. Chronic kidney disease and undiagnosed atrial fibrillation in individuals with diabetes. Cardiovasc. Diab. 2020;19(1):157. Doi: 10.1186/s12933-020-01128-y. [PMID: 32998739, PMCID: PMC7528591].Escobar Vasco M.A., Fantaye S.H., Raghunathan S., Solis-Herrera C. The potential role of finerenone in patients with type 1 diabetes and chronic kidney disease. Diab. Obes. Metab. 2024;26(10):4135–46. Doi: 10.1111/dom.15773. [Epub 2024 Jul 18, PMID: 39021345].Kumar M., Dev S., Khalid M.U. et al. The Bidirectional Link Between Diabetes and Kidney Disease: Mechanisms and Management. Cureus. 2023;15(9):e45615. Doi: 10.7759/cureus.45615. [PMID: 37868469, PMCID: PMC10588295].Yosefy O., Sharon B., Yagil C. et al. Diabetes induces remodeling of the left atrial appendage independently of atrial fibrillation in a rodent model of type-2 diabetes. Cardiovasc. Diab. 2021;20(1):149. Doi: 10.1186/s12933-021-01347-x. [PMID: 34301258, PMCID: PMC8306366].Dyntar D., Sergeev P., Klisic J. et al. High glucose alters cardiomyocyte contacts and inhibits myofibrillar formation. J. Clin. Endocrinol. Metab. 2006;91(5):1961–7. Doi: 10.1210/jc.2005-1904. [Epub 2006 Mar 7, PMID: 16522700].Pandey S., Madreiter-Sokolowski C.T., Mangmool S., Parichatikanond W. High Glucose-Induced Cardiomyocyte Damage Involves Interplay between Endothelin ET-1/ETA/ETB Receptor and mTOR Pathway. Int. J. Mol. Sci. 2022;23(22):13816. Doi: 10.3390/ijms232213816. [PMID: 36430296, PMCID: PMC9699386].Komada T., Muruve D.A. The role of inflammasomes in kidney disease. Nat. Rev. Nephrol. 2019;15(8):501–20. Doi: 10.1038/s41581-019-0158-z. [PMID: 31164720].Nagata D., Hishida E. Elucidating the complex interplay between chronic kidney disease and hypertension. Hypertens. Res. 2024;47(12):3409–22. Doi: 10.1038/s41440-024-01937-8. [Epub 2024 Oct 16, PMID: 39415028].Gawałko M., Linz D. Atrial Fibrillation Detection and Management in Hypertension. Hypertension. 2023;80(3):523–33. Doi: 10.1161/HYPERTENSIONAHA.122.19459. [Epub 2022 Dec 15, PMID: 36519436].Goette A., Staack T., Röcken C. et al. Increased expression of extracellular signal-regulated kinase and angiotensin-converting enzyme in human atria during atrial fibrillation. J. Am. Coll. Cardiol. 2000;35(6):1669–77. Doi: 10.1016/s0735-1097(00)00611-2. [PMID: 10807475].Liao J., Zhang S., Yang S. et al. Interleukin-6-Mediated-Ca2+ Handling Abnormalities Contributes to Atrial Fibrillation in Sterile Pericarditis Rats. Front. Immunol. 2021;12:758157. Doi: 10.3389/fimmu.2021.758157. [PMID: 34975847, PMCID: PMC8716408].Purohit A., Rokita A.G., Guan X. et al. Oxidized Ca(2+)/calmodulin-dependent protein kinase II triggers atrial fibrillation. Circulation. 2013;128(16):1748–57. Doi: 10.1161/CIRCULATIONAHA.113.003313. [Epub 2013 Sep 12, PMID: 24030498, PMCID: PMC3876034].Zhang M., Prosser B.L., Bamboye M.A. et al. Contractile Function During Angiotensin-II Activation: Increased Nox2 Activity Modulates Cardiac Calcium Handling via Phospholamban Phosphorylation. J. Am. Coll. Cardiol. 2015;66(3):261–72. Doi: 10.1016/j.jacc.2015.05.020. [PMID: 26184620, PMCID: PMC4509515].Liu Y., Lv H., Tan R. et al. Platelets Promote Ang II (Angiotensin II)-Induced Atrial Fibrillation by Releasing TGF-β1 (Transforming Growth Factor-β1) and Interacting With Fibroblasts. Hypertension. 2020;76(6):1856–67. Doi: 10.1161/HYPERTENSIONAHA.120.15016. [Epub 2020 Nov 11, PMID: 33175633].Moreira L.M., Takawale A., Hulsurkar M. et al. Paracrine signalling by cardiac calcitonin controls atrial fibrogenesis and arrhythmia. Nature. 2020;587(7834):460–5. Doi: 10.1038/s41586-020-2890-8. [Epub 2020 Nov 4, PMID: 33149301].Rouached M., El Kadiri Boutchich S., Al Rifai A.M. et al. Prevalence of abnormal serum vitamin D, PTH, calcium, and phosphorus in patients with chronic kidney disease: results of the study to evaluate early kidney disease. Kidney Int. 2008;74(3):389–90. Doi: 10.1038/ki.2008.169. [PMID: 18626497].Wang Q., Su W., Shen Z., Wang R. Correlation between Soluble α-Klotho and Renal Function in Patients with Chronic Kidney Disease: A Review and Meta-Analysis. Biomed. Res. Int. 2018;2018:9481475. Doi: 10.1155/2018/9481475. [PMID: 30159331, PMCID: PMC6109492].Viegas C., Araújo N., Marreiros C., Simes D. The interplay between mineral metabolism, vascular calcification and inflammation in Chronic Kidney Disease (CKD): challenging old concepts with new facts. Aging (Albany NY). 2019;11(12):4274–99. Doi: 10.18632/aging.102046. [PMID: 31241466, PMCID: PMC6628989].Mehta R., Cai X., Lee J., Chronic Renal Insufficiency Cohort (CRIC) Study Investigators. Association of Fibroblast Growth Factor 23 With Atrial Fibrillation in Chronic Kidney Disease, From the Chronic Renal Insufficiency Cohort Study. JAMA. Cardiol. 2016;1(5):548–56. Doi: 10.1001/jamacardio.2016.1445. [PMID: 27434583, PMCID: PMC4992989].Ruiz. S, Pergola P.E., Zager R.A., Vaziri N.D. Targeting the transcription factor Nrf2 to ameliorate oxidative stress and inflammation in chronic kidney disease. Kidney Int. 2013;83(6):1029–41. Doi: 10.1038/ki.2012.439. [Epub 2013 Jan 16,. PMID: 23325084, PMCID: PMC3633725].Gondouin B., Jourde-Chiche N., Sallee M. et al. Plasma Xanthine Oxidase Activity Is Predictive of Cardiovascular Disease in Patients with Chronic Kidney Disease, Independently of Uric Acid Levels. Nephron. 2015;131(3):167–74. Doi: 10.1159/000441091. [Epub 2015 Oct 2, PMID: 26426087].Luczak E.D., Anderson M.E. CaMKII oxidative activation and the pathogenesis of cardiac disease. J. Mol. Cell Cardiol. 2014;73:112–6. Doi: 10.1016/j.yjmcc.2014.02.004. [Epub 2014 Feb 13, PMID: 24530899, PMCID: PMC4048820].Pfenniger A., Yoo S., Arora R. Oxidative stress and atrial fibrillation. J. Mol. Cell Cardiol. 2024;196:141–51. Doi: 10.1016/j.yjmcc.2024.09.011. [Epub 2024 Sep 21, PMID: 39307416, PMCID: PMC12266930].Akchurin O.M., Kaskel F. Update on inflammation in chronic kidney disease. Blood Purif. 2015;39(1–3):84–92. Doi: 10.1159/000368940. [Epub 2015 Jan 20, PMID: 25662331].Navarro-Garcia J.A., Keefe J.A. et al. Mechanisms underlying atrial fibrillation in chronic kidney disease. J. Mol. Cell Cardiol. 2025;205:37–51. Doi: 10.1016/j.yjmcc.2025.06.002. [Epub 2025 Jun 9, PMID: 40499614].