Low-dose aspirin for the prevention of severe preeclampsia in patients with chronic kidney disease: a retrospective study

2021 ◽  
Author(s):  
Menglu Wang ◽  
Shi Chen ◽  
Yingdong He ◽  
Minghui Zhao ◽  
Huixia Yang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Retrospective Study ◽  
Kidney Disease ◽  
Low Dose ◽  
Severe Preeclampsia ◽  
Dose Aspirin ◽  
Low Dose Aspirin

scholarly journals Hazardous Effect of Low-Dose Aspirin in Patients with Predialysis Advanced Chronic Kidney Disease Assessed by Machine Learning Method Feature Selection

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1484
Author(s):  
Ming-Hsien Tsai ◽  
Hung-Hsiang Liou ◽  
Yen-Chun Huang ◽  
Tian-Shyug Lee ◽  
Mingchih Chen ◽  
...  
Keyword(s):  
Machine Learning ◽  
Chronic Kidney Disease ◽  
Feature Selection ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Low Dose ◽  
Machine Learning Method ◽  
Learning Method ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Background: Low-dose aspirin (100 mg) is widely used in preventing cardiovascular disease in chronic kidney disease (CKD) because its benefits outweighs the harm, however, its effect on clinical outcomes in patients with predialysis advanced CKD is still unclear. This study aimed to assess the effect of aspirin use on clinical outcomes in such group. Methods: Patients were selected from a nationwide diabetes database from January 2009 to June 2017, and divided into two groups, a case group with aspirin use (n = 3021) and a control group without aspirin use (n = 9063), by propensity score matching with a 1:3 ratio. The Cox regression model was used to estimate the hazard ratio (HR). Moreover, machine learning method feature selection was used to assess the importance of parameters in the clinical outcomes. Results: In a mean follow-up of 1.54 years, aspirin use was associated with higher risk for entering dialysis (HR, 1.15 [95%CI, 1.10–1.21]) and death before entering dialysis (1.46 [1.25–1.71]), which were also supported by feature selection. The renal effect of aspirin use was consistent across patient subgroups. Nonusers and aspirin users did not show a significant difference, except for gastrointestinal bleeding (1.05 [0.96–1.15]), intracranial hemorrhage events (1.23 [0.98–1.55]), or ischemic stroke (1.15 [0.98–1.55]). Conclusions: Patients with predialysis advanced CKD and anemia who received aspirin exhibited higher risk of entering dialysis and death before entering dialysis by 15% and 46%, respectively.

scholarly journals Low-dose aspirin was associated with an increased risk of cardiovascular events in patients with chronic kidney disease patients and low bodyweight: results from KNOW-CKD study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yun Jung Oh ◽  
Ae Jin Kim ◽  
Han Ro ◽  
Jae Hyun Chang ◽  
Hyun Hee Lee ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cardiovascular Events ◽  
Low Dose ◽  
Bleeding Event ◽  
Dose Aspirin ◽  
Increased Risk ◽  
Low Dose Aspirin ◽  
First Occurrence ◽  
Secondary Outcomes

AbstractThe benefits and risks of aspirin therapy for patients with chronic kidney disease (CKD) who have a high burden of cardiovascular events (CVE) are controversial. To examine the effects of low-dose aspirin on major clinical outcomes in patients with CKD. As a prospective observational cohort study, using propensity score matching, 531 aspirin recipients and non-recipients were paired for analysis from 2070 patients and fulfilled the inclusion criteria among 2238 patients with CKD. The primary outcome was the first occurrence of major CVE. The secondary outcomes were kidney events defined as a > 50% reduction of estimated glomerular filtration rate from baseline, doubling of serum creatinine, or onset of kidney failure with replacement therapy, the all-cause mortality, and bleeding event. The incidence of CVE was significantly greater in low-dose aspirin users than in non-users (HR 1.798; P = 0.011). A significant association between aspirin use and an increased risk of CVE was observed only in the lowest quartile of body weight (HR 4.014; P = 0.019) (Q1 < 60.0 kg). Secondary outcomes were not significantly different between aspirin users and non-users. It needs to be individualized of prescribing low-dose aspirin for the prevention of cardiovascular events in patients with chronic kidney disease, particularly patients with low bodyweight (< 60 kg).

scholarly journals Low-Dose Aspirin for Prevention of Cardiovascular Disease in Patients with Chronic Kidney Disease

PLoS ONE ◽  
2014 ◽  
Vol 9 (8) ◽  
pp. e104179 ◽  
Author(s):  
Ae Jin Kim ◽  
Hye Jin Lim ◽  
Han Ro ◽  
Kwang-Pil Ko ◽  
Song Yi Han ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Low Dose ◽  
Dose Aspirin ◽  
Low Dose Aspirin ◽  
Prevention Of Cardiovascular Disease

Low dose aspirin increases 15-epi-lipoxin A4 levels in diabetic chronic kidney disease patients

2017 ◽  
Vol 125 ◽  
pp. 8-13 ◽  
Author(s):  
Marian Goicoechea ◽  
Maria Dolores Sanchez-Niño ◽  
Alberto Ortiz ◽  
Soledad García de Vinuesa ◽  
Borja Quiroga ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Low Dose ◽  
Lipoxin A4 ◽  
Dose Aspirin ◽  
Low Dose Aspirin

Prenatal Low-Dose Aspirin Use Associated with Reduced Incidence of Postpartum Hypertension among Women with Preeclampsia

2021 ◽  
Author(s):  
Eleanor Christenson ◽  
Molly J. Stout ◽  
Dominique Williams ◽  
Amanda K. Verma ◽  
Victor G. Davila-Roman ◽  
...  
Keyword(s):  
Low Dose ◽  
Severe Preeclampsia ◽  
Exact Test ◽  
Hospitalization Rates ◽  
Dose Aspirin ◽  
Key Points ◽  
Low Dose Aspirin ◽  
Blood Pressures ◽  
Antiangiogenic Factors ◽  
Plgf Ratio

Objective Postpartum hypertension (PP-HTN), defined as systolic/diastolic blood pressure (SBP/DBP) ≥140/90, on two occasions at least 4 hours apart after delivery occurs in up to 50% of preeclamptic pregnancies, and is associated with adverse maternal outcomes. Excessive production of antiangiogenic factors (i.e., soluble fms-like tyrosine kinase 1 [sFLT1]) and reduced levels of proangiogenic factors (i.e., placental growth factor [PlGF]) are associated with preeclamptic pregnancies. The aim of this study was to identify clinical risk factors and/or serum biomarkers associated with PP-HTN in preeclampsia. Study Design Preeclamptic women (n = 82, aged ≥18 years) were prospectively enrolled in an observational study. Serial blood pressures were obtained through the labor course and until 48 hours postpartum, and serum was obtained within 24 hours postpartum. Statistical analysis was performed by using Student's two-tailed t-test and Fisher's exact test. Results Baseline comorbidities and antihypertensive use were similar among those who developed PP-HTN and those who did not. Among preeclamptic patients, 33% developed PP-HTN; these had significantly more severe preeclampsia features versus no PP-HTN (96 vs. 78%, p = 0.05). PP-HTN was associated with higher re-hospitalization rates (26 vs. 6%, p = 0.01). Among those taking low-dose aspirin (ASA) for preeclampsia prophylaxis (n = 12), PP-HTN was significantly less frequent versus those not taking low-dose ASA (0 vs. 22%, p = 0.007). Low-dose ASA use was associated with significantly lower peripartum sFLT1 levels (4,650 ± 2,335 vs. 7,870 ± 6,282 pg/mL, p = 0.03) and sFLT1/PlGF ratio (397 ± 196 vs. 1,527 ± 2,668, p = 0.03). Conclusion One-third of women with preeclampsia develop PP-HTN; these patients have more severe preeclampsia and have higher re-hospitalization rates. Prenatal low-dose ASA use was associated with significantly lower incidence of PP-HTN, reduced levels of antiangiogenic factors, and lower 6-week re-hospitalization rates. These findings, if replicated, may have clinical implications on the use of low-dose ASA during pregnancy to reduce incidence of postpartum HTN. Key Points

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