Use of Aspirin Associates with Longer Primary Patency of Hemodialysis Grafts

Bradley S Dixon; Gerald J Beck; Laura M Dember; Miguel A Vazquez; Arthur Greenberg; James A Delmez; Michael Allon; Jonathan Himmelfarb; Bo Hu; Tom Greene; Milena K Radeva; Ingemar J Davidson; T. Alp Ikizler; Gregory L Braden; Jeffrey H Lawson; James R Cotton; John W Kusek; Harold I Feldman; Dialysis Access Consortium (DAC) Study Group

doi:10.1681/ASN.2010060582

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Use of Aspirin Associates with Longer Primary Patency of Hemodialysis Grafts

Journal article

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Use of Aspirin Associates with Longer Primary Patency of Hemodialysis Grafts

Bradley S Dixon, Gerald J Beck, Laura M Dember, Miguel A Vazquez, Arthur Greenberg, James A Delmez, Michael Allon, Jonathan Himmelfarb, Bo Hu, Tom Greene, …

Journal of the American Society of Nephrology, Vol.22(4), pp.773-781

04/2011

DOI: 10.1681/ASN.2010060582

PMCID: PMC3065232

PMID: 21415156

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Abstract

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.

Clinical Research

Details

Title: Subtitle: Use of Aspirin Associates with Longer Primary Patency of Hemodialysis Grafts
Creators: Bradley S Dixon - Division of Nephrology, Department of Medicine, University of Iowa, Iowa City, Iowa
Gerald J Beck - Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
Laura M Dember - Division of Nephrology, Department of Medicine, Boston University, Boston, Massachusetts
Miguel A Vazquez - Division of Nephrology, Department of Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
Arthur Greenberg - Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina
James A Delmez - Renal Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri
Michael Allon - Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
Jonathan Himmelfarb - Kidney Research Institute, Department of Medicine, University of Washington, Seattle, Washington
Bo Hu - Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
Tom Greene - Division of Epidemiology, Department of Medicine, University of Utah, Salt Lake City, Utah
Milena K Radeva - Department of Quantitative Health Sciences, Cleveland Clinic Foundation, Cleveland, Ohio
Ingemar J Davidson - Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
T. Alp Ikizler - Division of Nephrology, Department of Medicine, Vanderbilt University, Nashville, Tennessee
Gregory L Braden - Division of Nephrology, Department of Medicine, Baystate Medical Center, Springfield, Massachusetts
Jeffrey H Lawson - Department of Surgery
James R Cotton - Tyler Nephrology Associates, Tyler, Texas
John W Kusek - Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland; and
Harold I Feldman - Renal Division, Department of Medicine, Washington University in St. Louis, St. Louis, Missouri
Dialysis Access Consortium (DAC) Study Group
Resource Type: Journal article
Publication Details: Journal of the American Society of Nephrology, Vol.22(4), pp.773-781
DOI: 10.1681/ASN.2010060582
PMID: 21415156
PMCID: PMC3065232
NLM abbreviation: J Am Soc Nephrol
ISSN: 1046-6673
eISSN: 1533-3450
Publisher: American Society of Nephrology
Language: English
Date published: 04/2011
Academic Unit: Anatomy and Cell Biology; Nephrology; Internal Medicine
Record Identifier: 9984094609402771

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