Use of aspirin associates with longer primary patency of hemodialysis grafts.

Dixon BS, Beck GJ, Dember LM, Vazquez MA, Greenberg A, Delmez JA, Allon M, Himmelfarb J, Hu B, Greene T, Radeva MK, Davidson IJ, Ikizler TA, Braden GL, Lawson JH, Cotton JR, Kusek JW, Feldman HI, Dialysis Access Consortium (DAC) Study Group
J Am Soc Nephrol. 2011 22 (4): 773-81

PMID: 21415156 · PMCID: PMC3065232 · DOI:10.1681/ASN.2010060582

Extended-release dipyridamole plus low-dose aspirin (ERDP/ASA) prolongs primary unassisted graft patency of newly created hemodialysis arteriovenous grafts, but the individual contributions of each component are unknown. Here, we analyzed whether use of aspirin at baseline associated with primary unassisted graft patency among participants in a randomized trial that compared ERDP/ASA and placebo in newly created grafts. We used Cox proportional hazards regression, adjusting for prespecified baseline comorbidities and covariates. Of all participants, 43% reported use of aspirin at baseline; of these, 82% remained on nonstudy aspirin (i.e., excluding ERDP/ASA) at 1 year. After 1 year of follow-up, the incidence of primary unassisted patency among participants using aspirin at baseline was 30% (95% CI: 24 to 35%) and among those not using aspirin was 23% (95% CI: 18 to 27%). Use of aspirin at baseline associated with a dose-dependent prolongation of primary unassisted graft patency that approached statistical significance (adjusted HR, 0.83; 95% CI: 0.68 to 1.01; P=0.06). Use of aspirin at baseline did not associate with prolongation of cumulative graft patency or participant survival. In conclusion, use of aspirin associates with a trend toward longer primary unassisted patency of newly placed hemodialysis grafts similar to that observed for ERDP/ASA.

Copyright © 2011 by the American Society of Nephrology

MeSH Terms (21)

Adult Aged Arteriovenous Shunt, Surgical Aspirin Aspirin, Dipyridamole Drug Combination Chronic Disease Dipyridamole Drug Combinations Drug Therapy, Combination Female Follow-Up Studies Humans Kidney Diseases Male Middle Aged Platelet Aggregation Inhibitors Proportional Hazards Models Renal Dialysis Thrombosis Treatment Outcome Vascular Patency

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