Arrhythmia Alliance
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Is anybody suffering from CKD as well as Atrial Fibrillation?

I have paroxysmal AFib since 2010 and 2 months ago was diagnosed with CKD stage 3. Needless to say this was a real shock. I have the PAF mostly under control with Flecainide slow release 150mg per day. I have no side effects. It is so effective that my last attack was July last year and lasted for about 2 hours only. It was also very mild. However, I'm beginning to wonder if the med is bad for kidneys. It gets excreted via the kidneys, which is obviously not helping them. I am not on anticoagulants.

I would really like to know if others here are in the same boat and if so, how are you coping and do you have any advise regarding this double onslaught.

I would appreciate any thoughts.

Thanks Barty.

19 Replies
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Hi Barty, was is CKD?

Jean

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Hi Jean CKD is stages of kidney disease

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Hi

CKD stands for chronic kidney disease. If you don't know the abbreviation then you're unlikely to have it. 😊

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True, but my theory is that one response to a post leads to more.

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Hi Barty

I was diagnosed with AF in Jan 2014 although suspect I had it a couple of years before that - I was very symptomatic. I had an ablation Nov 2014 and because I stayed bad with AF in fact I think I got worse in Sept 2015 I had a second ablation. During 2015 my kidney function deteriorated my eGFR going from >60 down to 57 then 52 and 48 on one hospital stay (so stage 3b I believe). Since I have been largely AF free and came off warfarin and all other drugs it recovered to >60 on all subsequent tests - even this year when I’ve had flutter return and gone back on to propafenone and Rivaroxaban. So I believe at these stages it can be reversible and as a result of being poorly and/or the drugs. Don’t panic I felt doomed that it was the start of yet another health problem but it hasn’t been. I also read up a bit and drank more water and changed diet a bit to try and help it along (not sure it did).

Take care.

Jo

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Hi Jo

Two ablations so close together? I hope to avoid this. I'm on flecainide slow release which keeps the Afib almost 100% in check. Very rarely do I have even a minor attack. My eGFR is now 50 but has decreased very fast over the last two years. If it continues like that I shall be down to 14 in 6 years' time. Not a happy prospect. The problem is that very little can be done to stop progression. I don't eat a lot of meat (no red for years) and plenty of fruit/ veg. I'm not overweight, don't smoke/drink, no diabetes but have controlled BP. I feel quite helpless and unsure what else I can do. The doctor says wait until you have reached stage 4.

I'm amazed you managed to get back to above 60 from 48! It must have been the result of being ill. I'd be happy if it just did not get worse in my case. I have another blood/urine test on Friday.

I'm not on anti coagulants since my afib is so rare and only very brief episodes.

How is your Afib now?

Barty

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I don’t really suffer from AF anymore and it was very fast and incapacitating and limited drug options but have had a very persistent atypical flutter in this last year (likely a breakthrough circuit) which starts and sticks around the last 2 times only converted with a cardioversion after a month. However I have a slow heart rate and am waiting for a pacemaker so will not do anything about this until after that as it could be the slow heart letting it start and the pacemaker might resolve it. It must be difficult to consider a change in drug if you know this one is working for your AF. My GP has CKD on my notes so I always have it checked whenever I have anything but hospital always disputes it as says >60 for so long now. The other big culprits are high blood pressure and ironically blood pressure tablets so if you have either of those might be worth considering a change.

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Hi Jo

If your eGFR is 60 you have nothing to worry about. That is still a normal level.

My BP tablets are if the ARBS family which is supposed to be kidney friendly. I'm pretty much at a loss with the CKD.

Regards Barty

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Hi

I know I’m in the clear now they just like to keep an eye on it given it dipped in the past. It’s a shame the doctors aren’t more proactive in understanding cause trying to arrest it at an early stage when it has the potential to recover.

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Hi Jo

You probably never had CKD but Acute Kidney Injury as a result of being ill. This condition is reversible, which appears to have been so in your case. I don't believe CKD is actually reversible. Once the kidneys are damaged, no meds can undo it. Rather like muscle which has died in a heart attack. That cannot be healed either. It's a case of damage limitation. Whilst there are lots of quite effective heart drugs, this does not seem to be the case with kidney disease.

It's a big worry for all those affected. Progression of CKD is very individual. Medicine is mostly still Art, not Science. Unfortunately.

It's good that you are better though.

Regards Barty.

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Hi barty how do you know that yours is CKD then? Have they said your kidneys are irreversibly damaged? Have they done scans and tests to confirm that? As my eGFR dropped over 12 points to 48 over a series of tests spanning about 18 months in the same manner as yours - it was noted as CKD on my GP notes because of this. Have they given you a cause? If not I would consider your BP meds as they are a prime candidate and I believe that there are many different alternative ones you can try. I am seriously not trying to deny your issues but would explore the easiest and plausible explanation - if you can try any changes it is surely worth exploring before admitting defeat. It was the first thing the nurse said to me ‘it’ll be your high blood pressure or your blood pressure medication’ neither of which I have.

I too am very pleased this is resolved as I now have other conditions Pulmonary Hypertension and Small Airway Disease. Please explore your options before you sink into despondency.

Take care I wish you to be well.

Jo

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Hi Jo

Thank you for a very encouraging reply. I do know it is CKD because - unlike you - I have not been ill. According to my various blood tests I can trace the deterioration back to Oct 2015.

For me, the fact that your eGfr recovered to such an extend, proves that it could not be CKD and of course, the fact that you had been quite ill which can affect your creatinine levels enormously.

But thank you for your helpful suggestions. My BP meds are already of the kidney friendly type in addition to which I take statins. But neither are these suspect in damaging kidneys.

I have had an ultra sound which showed normal size and shape of kidneys without blockages. However, the functioning of them can only be established by CT/MRI scan. Even then it does not tell you the reason for the problem. It's rather like: why do some people get heart attacks/cancer some not. What I find to be shocking is the fact that there are no meds which can stop the progression of CKD. It may be slow, sometimes it even stops but that is rare. However, since it is predominantly an illness of old age, the majority of those affected never get to stage 5 when the only options are either dialysis or transplant. How depressing.

Btw, are you in the UK? I live in the South East. No nephrologists down here!

Thank you for your support. It is much appreciated.

Barty

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Hi.Barty I also have Af,heart failure ckd stage 3 along with other associated illnesses...I have a blood test every 6 weeks to keep an eye on my U and E,s and my egfr fluctuates

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What meds do you take for Afib and do you do anything that might slow down the CKD? Diet often gets mentioned but my doctor says it makes no difference. Obviously a healthy diet. Do you know since when you have CKD and how fast it has progressed? Mine progessed about 10% per year, which is very fast. No idea why. Just very worrying. What is your presend eGFR?

Barty

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Barty, With regards to CKD it depends how old you are. I have CKD stage 3 at the age of 70 but that is to be expected and not really something to worry about because as you age your kidneys age also.

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Hi badennett

Thanks for the reply. Apparently about 20% of prople with Afib also end up having CKD.

I would not be too concerned by it except that mine has progressed by 20% in just over 2 years. If I project this figure into the future, I’ll be down to a GFR of 26 in 6 years’ time. Although, as I’m 74 I should not be greedy, 80 is a good age! 😉

I just hope any progression does not accelerate. I have another three monthly blood and urine test tomorrow. I felt like cancelling all of today. I’ve been following a very low protein diet but with lots of fruit and vege, no salt and we’ll see if that has impacted positively on my creatinine level.

Do you know how fast your CKD has progressed? Do you see a nephrologist and have you had any scans?

Yes, kidneys do age as you say but function should not decline by so much and so quickly- even with age. I’m not diabetic but have controlled BP.

In a way I wish I’d never been told about it since there is nothing anyone can do. I could have lived quite happily in ignorance until I got symptoms.

Anyhow, hope to hear from you again.

Barty

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Hi Barty 11 Mine was 74 in 2009 and 63 in 2016. I am feeling fine and have not been advised to change my lifestyle.

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Hi Badennett

Thank you for such a quick reply. Could you just tell me please what your GFR is now?

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Hi again

I just see that your progression in 11 years was just over 1.5 points per year. Mine is 6 points per year. Quite a difference. Of course there is no need for you to worry with those figures. It's a different matter for me though. 😪

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