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KMID : 0359920110300020163
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Korean Journal of Nephrology
2011 Volume.30 No. 2 p.163 ~ p.170
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Aspirin Resistance in Patients with End-Stage Renal Disease
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Kim Hyun-Woo
Jang Eun-Hee
Kim Song-Yi
Kim Ki-Seok
Joo Seung-Jae
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Abstract
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Purpose:Patients with end-stage renal disease (ESRD) frequently undergo thrombotic cardiovascular events, but the relationship between increased thrombotic events and aspirin resistance is poorly defined in these patients.
Methods:Between December 2008 and November 2009, 59 ESRD patients who had taken aspirin alone or aspirin plus clopidogrel daily for ≥7 consecutive days were included. Aspirin resistance was measured using the VerifyNow Aspirin Assay and compared with that of patients with normal kidney function. Moreover, thrombotic cardiovascular events were examined in the ESRD patients.
Results:Aspirin reaction unit was 475±58 U in the ESRD patients compared with 443±62 U in patients with normal kidney function. Nineteen (11%) of 170 patients were aspirin resistant based on the criterion of aspirin reaction unit (≥550). The prevalence of aspirin resistance was significantly higher in the ESRD patients than in control patients (20% vs. 6%, p=0.006). ESRD and the use of angiotensinconverting enzyme inhibitors were associated with aspirin resistance in the multivariate logistic regression analysis. After a mean follow-up of 18.6±7.5 months, the incidence of thrombotic cardiovascular events in the ESRD patients who had aspirin resistance was significantly higher than in the ESRD patients without aspirin resistance (75% vs. 38%, p=0.023).
Conclusion:The incidence of aspirin resistance was higher in patients with ESRD than in patients with normal kidney function. In addition, ESRD and the use of angiotensin-converting enzyme inhibitors were significant predictors for aspirin resistance. Aspirin resistance was associated with increased thrombotic cardiovascular events in ESRD patients.
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KEYWORD
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Low molecular weight heparin, Bleeding, Renal insufficiency
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