The safety of low dose aspirin in chronic kidney disease patients

• Main Authors: Hsuan-ting Teng, 鄧軒婷
• Other Authors: Jui-Chen Tsai
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/73945093344302458235

碩士 === 國立成功大學 === 臨床藥學研究所 === 96 === Background： Chronic kidney disease (CKD) is becoming a worldwide health problem and the prevalence and incidence are growing fast. CKD is associated with an increased risk of adverse cardiovascular outcomes and is considered a cardiovascular disease (CVD) risk equivalent. Long-term low-dose aspirin therapy reduces the risk of subsequent myocardial infarction (MI), stroke, and vascular death among patients with a wide range of prior manifestations of cardiovascular disease. According to clinical studies, patients with CKD have been largely excluded from clinical trials of patients with coronary artery disease. The influences of aspirin are inconsistent in CKD. There is still no good evidence of the safety of using low dose aspirin in CKD patients. Objective： To evaluate the effects of low-dose aspirin on the renal function, all causes of mortality and bleeding events of CKD patients. Method： We enrolled CKD patients of serum creatinine (SCr) ≧ 1.5 mg/dL at entry of the study in National Cheng Kung University Hospital from Jan 2003 to Dec 2003. The patients were grouped into aspirin group and control group. They were followed these patients until Dec, 2007. Main outcome measures： The primary outcome was defined as a 50% increase of SCr or initiation of dialysis therapy and all causes of mortality. The secondary outcome was the bleeding events. Results： Among 117 CKD patients, 57 were Aspirin group and 60 were control group. Low-dose aspirin significantly reduced renal impairment and all-cause of mortality rate. About major and minor bleeding, there are no significant differences between Aspirin and control group. After rule out patients with history of GI ulcer, major bleeding is no significant difference between Aspirin and control group (1：2, p=0.488）; but minor bleeding in Aspirin group is significantly higher than control group ( 11：3, p=0.036）. Conclusion: Long-term use of low-dose aspirin had renal protection and reduced all-cause mortality in chronic kidney disease patients. There was no excess of major bleeds, but minor bleeding was significantly increased.