Consistent aspirin use associated with improved arteriovenous fistula survival among incident hemodialysis patients in the dialysis outcomes and practice patterns study.

Abstract

BACKGROUND AND OBJECTIVES:

The relationship between aspirin use and arteriovenous fistula (AVF) survival has been lacking. The aim of this study was to evaluate the association between AVF survival and aspirin use.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS:

Data on 2815 incident hemodialysis patients (on dialysis <or= 30 d) using an AVF at enrollment into the Dialysis Outcomes and Practice Patterns Study between 1996 and 2004 were analyzed. Cox regression was used to examine the association between aspirin use and the risk of final AVF failure, first AVF failure, and a gastrointestinal bleeding event. Aspirin use was determined at baseline and one year later. Patients using aspirin at baseline and one year later were considered consistent aspirin users. All models accounted for facility clustering effects and were adjusted for age, race, gender, body mass index, prior permanent access failure, prior placement of a catheter, 10 comorbid conditions, laboratory data, and other medications, and stratified by regions.

RESULTS:

Consistent aspirin use was significantly related to a lower risk of final AVF failure. Facility-level analysis, which may reduce confounding by indication, also showed a nearly significant trend of reduced risk of final AVF failure with greater prevalence of consistent aspirin use within dialysis facilities (P for trend = 0.07). The occurrence of a new gastrointestinal bleeding event during the study period was not associated with aspirin use.

CONCLUSIONS:

These results suggest that consistent aspirin use may be beneficial for AVF survival among incident hemodialysis patients.

• Authors: Takeshi Hasegawa, Stacey J Elder, Jennifer L Bragg-Gresham, Ronald L Pisoni, Shin Yamazaki, Tadao Akizawa, Michel Jadoul, Rayner C Hugh, Friedrich K Port, Shunichi Fukuhara
• Journal: Clinical journal of the American Society of Nephrology : CJASN (Clin J Am Soc Nephrol) Vol. 3 Issue 5 Pg. 1373-8 (Sep 2008) ISSN: 1555-905X [Electronic] United States
• PMID: 18596119 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Platelet Aggregation Inhibitors
• Aspirin

Topics

• Aged
• Arteriovenous Shunt, Surgical (adverse effects)
• Aspirin (adverse effects, therapeutic use)
• Australia
• Europe
• Female
• Gastrointestinal Hemorrhage (chemically induced)
• Graft Occlusion, Vascular (etiology, physiopathology, prevention & control)
• Humans
• Incidence
• Japan
• Kidney Failure, Chronic (therapy)
• Male
• Middle Aged
• New Zealand
• North America
• Platelet Aggregation Inhibitors (adverse effects, therapeutic use)
• Proportional Hazards Models
• Prospective Studies
• Renal Dialysis
• Risk Assessment
• Time Factors
• Vascular Patency (drug effects)