To compare clinical epidemiological features of atrial fibrillation (AF) in chronic kidney disease (CKD) and non-CKD populations.

This study included 88,312 adults aged ≥45 years old from the KAILUAN study. AF was ascertained with a 12-lead electrocardiogram. CKD was defined as an estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m² and/or proteinuria. Participants were categorized into non-CKD (eGFR > 60 mL/min/1.73 m² without proteinuria, n = 66,725) and CKD (n = 21,578) groups. We evaluated the prevalence of AF in both groups, evaluated risk factors for AF using multivariable-adjusted logistic regression analysis.

The prevalence of AF among non-CKD and CKD participants was 0.26% and 1.00%, respectively. Multivariable-adjusted analysis showed that older age (odds ratio [OR]: 1.08, 95% confidence interval [CI]: 1.07–1.10, P < 0.001), smoking (OR: 1.23, 95% CI: 1.07–1.57, P = 0.017), hypertension (OR: 2.14, 95% CI: 1.44–3.17, P < 0.001), diabetes (OR: 1.79, 95% CI: 1.10–2.89, P < 0.001), and larger waist circumference (OR: 1.03, 95% CI: 1.01–1.04, P < 0.001) were significantly associated with AF in the non-CKD group. In the CKD group, older age, smoking, larger waist circumference, reduced eGFR (OR: 0.97, 95% CI: 0.95–0.99, P < 0.001), proteinuria (OR: 2.01, 95% CI: 1.09–3.74, P < 0.001) and raised serum C-reactive protein (1.01, 1.00–1.03, P < 0.001) were significantly associated with AF.

The prevalence of AF in Chinese adults with CKD is higher than that among those without CKD. Risk factors for AF in non-CKD population were not the same compared with those in CKD population, kidney function and inflammatory markers were associated with the prevalence of AF.