Renal Dysfunction following Direct Current Cardioversion of Atrial Fibrillation: Incidence and Risk Factors

Nicolai Grüner-Hegge, Danesh K. Kella, Deepak Padmanabhan, Abhishek J. Deshmukh, Ramila Mehta, David Hodge, Rowlens M. Melduni, Eddie L. Greene, Paul A. Friedman

Research output: Contribution to journalArticlepeer-review


Introduction: Emerging data suggest that cardioversion for atrial fibrillation (AF) may be associated with acute kidney injury (AKI). However, limited data are available regarding the incidence and risk factors for AKI after direct current cardioversion (DCCV) of AF. Methods: All patients undergoing DCCV at Mayo Clinic between 2001 and 2012 for AF were prospectively enrolled in a database. All patients with serum creatinine (SCR) values pre- A nd post-cardioversion were reviewed for AKI, defined as a ≥25% decline in eGFR (estimated glomerular filtration rate) from baseline value within 7 days of the DCCV. Results: Of the 6,427 eligible patients, 1,256 (19.5%) patients had pre- A nd post-DCCV SCR available and formed the cohort under study. The mean age was 70.4 (SD 11.7) years, and 67.3% were male. During the study period, 131 (10.4%) patients suffered from AKI following DCCV. AKI was independently associated with inpatient status (OR 26.79; 95% CI 3.69-194.52), CHA2DS2-VASc score (OR 1.25; 95% CI 1.11-1.41), prior use of diuretics (OR 1.59; 95% CI 1.03-2.46), and absence of CKD (OR 1.61; 95% CI 1.04-2.49), and was independent of the success of the DCCV. None of the patients required acute dialysis during the study outcome period. Conclusion: AKI following DCCV of AF is common, self-limited, and without the need for replacement therapies.

Original languageEnglish (US)
Pages (from-to)27-32
Number of pages6
JournalCardioRenal Medicine
Issue number1
StatePublished - Feb 2021


  • Acute kidney injury
  • Atrial fibrillation
  • Direct current cardioversion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Urology


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