title: Low-dose aspirin for prevention of cardiovascular disease in patients with chronic kidney disease.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a major risk factor for the development of cardiovascular disease (CVD). Previous trials have investigated the effects of low-dose aspirin on CVD prevention in patients with diabetes; however, patients with CKD were not examined. The role of aspirin in diabetics is controversial, and the available literature is contradictory. Therefore, we studied whether low-dose aspirin would be beneficial for patients with CKD, a group that is at high risk for CVD.
  
  
  METHODS
  From a total of 25340 patients with CKD, 1884 recipients of low-dose aspirin (100 mg/day) were paired 1∶1 with non-recipients for analysis using propensity score matching. The primary endpoint was the development of atherosclerotic CVD, including coronary arterial disease, stroke, and peripheral arterial disease. Secondary endpoints included death from any cause, bleeding events, doubling of serum creatinine, and renal death.
  
  
  RESULTS
  The incidence of a primary endpoint of any atherosclerotic CVD was significantly higher in the aspirin users than in the non-users (P<0.001). Secondary endpoints, including all-cause mortality and composite bleeding events, were not significantly different between the aspirin users and the non-users. However, the doubling of serum creatinine levels (P = 0.001) and renal death (P = 0.042) were significantly associated with the use of aspirin.
  
  
  CONCLUSIONS
  These results suggest that the use of low-dose aspirin in patients with CKD may have harmful consequences related to the development of CVD and renal progression.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Ae Jin
authors.initials: AJ
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Lim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea; Gachon University School of Medicine, Incheon, Korea.
authors.forename: Han
authors.initials: H
authors.lastname: Ro
authors.affiliation: Department of Preventive Medicine, Gachon University School of Medicine, Incheon, Korea.
authors.forename: Kwang-Pil
authors.initials: KP
authors.lastname: Ko
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
authors.forename: Song Yi
authors.initials: SY
authors.lastname: Han
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea; Gachon University School of Medicine, Incheon, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Chang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea; Gachon University School of Medicine, Incheon, Korea.
authors.forename: Hyun Hee
authors.initials: HH
authors.lastname: Lee
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea; Gachon University School of Medicine, Incheon, Korea.
authors.forename: Wookyung
authors.initials: W
authors.lastname: Chung
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea; Gachon University School of Medicine, Incheon, Korea.
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Jung
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality / Q000517:prevention & control*; D003920:Diabetes Mellitus; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000319:Adrenergic beta-Antagonists; D001241:Aspirin
references.citation: JAMA. 2007 Nov 7;298(17):2038-47
references.pmid: 17986697
references.citation: BMJ. 2013 Oct 03;347:f5680
references.pmid: 24092942
references.citation: Curr Cardiol Rep. 2013 Mar;15(3):340
references.pmid: 23338722
references.citation: J Am Soc Nephrol. 2009 Oct;20(10):2269-76
references.pmid: 19696225
references.citation: Kidney Int. 2006 Dec;70(11):2021-30
references.pmid: 17051142
references.citation: Ann Intern Med. 2012 Aug 21;157(4):263-75
references.pmid: 22910937
references.citation: Clin J Am Soc Nephrol. 2011 Jun;6(6):1385-92
references.pmid: 21393492
references.citation: J Am Soc Nephrol. 2008 Jan;19(1):135-40
references.pmid: 18032796
references.citation: Am J Med Sci. 1998 Aug;316(2):94-104
references.pmid: 9704663
references.citation: Kidney Int. 2004 Mar;65(3):1009-16
references.pmid: 14871421
references.citation: Adv Chronic Kidney Dis. 2008 Oct;15(4):370-7
references.pmid: 18805383
references.citation: Ann Intern Med. 2001 Apr 17;134(8):629-36
references.pmid: 11304102
references.citation: Am Heart J. 2002 Aug;144(2):226-32
references.pmid: 12177638
references.citation: J Am Coll Cardiol. 2010 Mar 16;55(11):1139-46
references.pmid: 20223369
references.citation: Circulation. 2008 Mar 18;117(11):1449-59
references.pmid: 18347221
references.citation: Nephrol Dial Transplant. 2013 Aug;28(8):2116-22
references.pmid: 23729489
references.citation: Prev Cardiol. 2010 Winter;13(1):18-22
references.pmid: 20021622
references.citation: Thromb Haemost. 1996 Sep;76(3):312-21
references.pmid: 8883263
references.citation: Am J Kidney Dis. 2007 Oct;50(4):602-11
references.pmid: 17900460
references.citation: J Am Coll Cardiol. 2010 Sep 14;56(12):956-65
references.pmid: 20828648
references.citation: Semin Thromb Hemost. 2004 Oct;30(5):579-89
references.pmid: 15497100
references.citation: Ann Intern Med. 2012 Mar 20;156(6):445-59
references.pmid: 22431677
references.citation: Clin Pharmacol Ther. 2009 Nov;86(5):553-6
references.pmid: 19776735
references.citation: Am J Nephrol. 2012;36(4):342-7
references.pmid: 23107930
references.citation: Exp Ther Med. 2012 Mar;3(3):530-534
references.pmid: 22969924
references.citation: Lancet. 2009 May 30;373(9678):1849-60
references.pmid: 19482214
references.citation: Am J Kidney Dis. 2002 Feb;39(2 Suppl 1):S1-266
references.pmid: 11904577
references.citation: Ann Intern Med. 2009 Mar 17;150(6):396-404
references.pmid: 19293072
references.citation: Circulation. 2010 Jun 22;121(24):2694-701
references.pmid: 20508178
references.citation: Am J Kidney Dis. 2005 Mar;45(3):473-84
references.pmid: 15754269