Dipyridamole has been shown to decrease
proteinuria and improve renal function progression especially in early
chronic kidney disease (CKD) patients with glomerulonephropathy. A combination
therapy of
dipyridamole with
aspirin could prevent second
strokes in the general population. Whether these effects of
dipyridamole are also true in advanced CKD patients and whether
dipyridamole could improve renal outcomes or patient survival is unknown. We retrospectively analyzed an observational cohort of 3074 participants with CKD stage 3-5 from southern Taiwan, of whom 871 (28.3%) had received
dipyridamole treatment ≥50 mg/d for ≥3 months and more than half of the observation period. The mean age was 63.6 ± 13.4 years and the mean estimated glomerular filtration rate (eGFR) was 25.5 mL/min/1.73 m(2). After inverse probability of treatment weighted adjustment by propensity score, there were no differences between the
dipyridamole-treated and untreated groups.
Dipyridamole treatment was associated with decreased odds for rapid eGFR decline [odds ratio, 0.755; 95% confidence interval (CI), 0.595-0.958; p = 0.007] and progression of urine
protein-to-
creatinine ratio (odds ratio, 0.655; 95% CI, 0.517-0.832; p = 0.002). In survival analysis, the
dipyridamole-treated group was also associated with a decreased risk for
end-stage renal disease (hazard ratio, 0.847; 95% CI, 0.733-0.980; p = 0.011) and all-cause mortality (hazard ratio, 0.765; 95% CI, 0.606-0.971; p = 0.001) but not for cardiovascular events. Our findings demonstrate that
dipyridamole treatment is significantly associated with better renal outcomes and patient survival in patients with CKD stage 3-5. Further investigations are warranted to confirm these independent positive effects.