Long-term aspirin (ASA) use may be associated with slower deterioration of renal function and decreased risk for death among patients with chronic kidney disease (CKD), according to study findings presented at the American Society of Nephrology’s Kidney Week 2021 conference.

In a study of 856 US veterans with nondialysis CKD, a team led by Csaba P. Kovesdy, MD, of the University of Tennessee Health Science Center in Memphis, examined the association of long-term ASA use (90 days or more) with mortality and a combined renal endpoint of dialysis initiation or a 40% or greater decline in estimated glomerular filtration rate (eGFR). The study population consisted of 653 patients on long-term ASA therapy and 203 ASA nonusers (controls). Of the 653 ASA patients, 7.8% did not receive low-dose ASA (less than 200 mg per day).

Over a median follow-up period of 4.8 years, 315 patients (36.7%) reached the combined renal endpoint (236 in the ASA group and 79 in the control arm) and 373 patients (43.5%) died (277 in the ASA group and 96 in the control arm).


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In a fully adjusted model, patients in the ASA group had a significant 45% lower risk for the renal end point and 47% lower risk for death compared with nonusers, Dr Kovesdy and colleagues reported.

The investigators adjusted for demographics, body mass index, smoking status, comorbidities, steroid use, baseline eGFR, proteinuria, medication adherence, and other potential confounders.

“Microinflammation may be a mechanism contributing to adverse outcomes in patients with CKD,” Dr Kovesdy told Renal & Urology News. “Low-dose ASA is usually used as an antiplatelet agent for cardiovascular indications, but may also have beneficial effects by reducing microinflammation. We found an association between long-term ASA use and lower risk of a composite renal outcome and mortality in a single center cohort of patients with CKD. These results will have to be replicated in larger and more diverse cohorts and potentially in future clinical trials, before we can recommend ASA for renoprotection.”

Reference

Lu JJL, Thomas F, Sumida K, Hassan WW, Kovesdy CP. Association of long-term aspirin use with progression of kidney disease. Presented at: Kidney Week 2021, November 2-7, 2021. Poster PO2379.