Aspirin

[G.Lively]

Will aspirin have a negative effect on people with partial kidney function?  Need to know.
Will Warfarin have a negative effect on a partial kidney function?

[cattlekid]

Two questions to which I do not have an official answer.

Unofficially, I had a heart attack in 2012 after starting dialysis in 2011.  I was put on low-dose (81 mg) aspirin after my heart attack and continue to be on it to this day, even after transplant.  No one in a medical capacity has ever mentioned that it might not be a good idea to stay on low-dose aspirin. I have a feeling that little yellow pill will be in my daily pill case for the rest of my life.

[obsidianom]

Talk to your nephrologist. Aspirin can be an issue with kidney disease as clotting and platelet fuction is reduced with kidney disease and aspirin can add to the bleeding problem.
BE CAREFUL. dont do anything without talking to your own doctor.

[KatieV]

After my first transplant, I was put on 81mg aspirin by the transplant team.  This time, at the same transplant center, no aspirin.  I second the advice to ask your doctor.

[Deanne]

My neph told me to take a full-dose (325 mg) aspirin daily after I had a blood clot several years ago for no known reason. She goes through my meds list regularly and it's always on there.

[G.Lively]

Interesting!

After dialysis for eight months, my health went to hell.  I now have  chronic bronchitis, pulmanory embolism caused by that chest catheter and the Doctor has me on Warfarin which gave me three months of the hersey squirts.  I read two scientific studies that claimed aspirin works fine  for a pulmonary embolism.  He didn't buy it.  This is my fifth doctor on the chronic bronchitis and I now have five different opinions on treatment which includes sleep clinic and surgery.  He wouldn't release me from Warfarin.  CT scan instead to cover his ass.  Blood test tomorrow, my fourth of the month.  I gave him the blood test results from Friday.  No soap - a doctor is never wrong.  I am close to telling every doctor I know to shove it up their - - - ear.

Among other things, I have learned that doctors do not like "No" and that includes my Nephrologist who did not want to perform the tests that eventually released me from Dialysis.  I had renal failure because of a misdiagnosis, he said constipation and it was cancer which blocked kidney function.  After five months they carried me into the hospital unconscious. From then on it was downhill.  I told the doctor today I didn't trust doctors anymore and he did not appreciate me quoting the New England Journal of Medicine or the National Health Institute.  It was the doctors who prescribed Norco back when I was in that hospital.  That worked its way up to six pills a day for no particular reason.  Before Christmas I cold turkeyed all six of those pills.  I don't know if I can ever forgive the bat-shit crazy doctors who did that to me.

I truly do not like closed minded people.  I do not like those who cannot be swayed from their religion, meaning doctors and their medicine.  Telling the doctor that it was my body gained no traction.  Am I pissed?  I made an appointment with a shrink, I need a third non-MD opinion.  And I will not find a sixth doctor.

I cannot offer an opinion on aspirin and kidney function.  Some places say do it, others say don't. 

[Jean]

G.L.
You mentioned Norco briefly and you were taking 6 pills a day. Why were you taking it, may I ask? And, what did it do to you. You probably already figured I take it and will soon be going to pain management, but I only take 3 pills a day. I am curious about what it did to you.

[obsidianom]

Interesting!

After dialysis for eight months, my health went to hell.  I now have  chronic bronchitis, pulmanory embolism caused by that chest catheter and the Doctor has me on Warfarin which gave me three months of the hersey squirts.  I read two scientific studies that claimed aspirin works fine  for a pulmonary embolism.  He didn't buy it.  This is my fifth doctor on the chronic bronchitis and I now have five different opinions on treatment which includes sleep clinic and surgery.  He wouldn't release me from Warfarin.  CT scan instead to cover his ass.  Blood test tomorrow, my fourth of the month.  I gave him the blood test results from Friday.  No soap - a doctor is never wrong.  I am close to telling every doctor I know to shove it up their - - - ear.

Among other things, I have learned that doctors do not like "No" and that includes my Nephrologist who did not want to perform the tests that eventually released me from Dialysis.  I had renal failure because of a misdiagnosis, he said constipation and it was cancer which blocked kidney function.  After five months they carried me into the hospital unconscious. From then on it was downhill.  I told the doctor today I didn't trust doctors anymore and he did not appreciate me quoting the New England Journal of Medicine or the National Health Institute.  It was the doctors who prescribed Norco back when I was in that hospital.  That worked its way up to six pills a day for no particular reason.  Before Christmas I cold turkeyed all six of those pills.  I don't know if I can ever forgive the bat-shit crazy doctors who did that to me.

I truly do not like closed minded people.  I do not like those who cannot be swayed from their religion, meaning doctors and their medicine.  Telling the doctor that it was my body gained no traction.  Am I pissed?  I made an appointment with a shrink, I need a third non-MD opinion.  And I will not find a sixth doctor.

I cannot offer an opinion on aspirin and kidney function.  Some places say do it, others say don't.

While I am not a big fan of warfarin in general, I dont agree with you on the aspirin after a pulmonary embolism. The studies on aspirirn as a prophylactic for embolism are generally for orthopedic surgery and are not for after you have had an actual episode of embolism. Having already had an embolism you are a high risk patient for another and aspirin is not really proven in this case. Pulmonary embolism can KILL quickly and you already escaped one luckily, but the next time could be fatal. So based on what you staed here your doctor was following protocol.
Now I understand your frustration with some doctors. There are some real jerks out there. Any doctor who wont listen to a patient is a fool in my book. Even as a physician I have seen my share of jerks for myself and my wife. We are just able to avoid most of them and find the decent ones. And there are  some decent doctors who do care. You just need to look hard.

[jeannea]

I think you have to do the standard risk/benefit calculation with your docs. If you need the warfarin to prevent a problem, then you may need it regardless of kidney function. It doesn't help to preserve your kidneys if you die of a stroke. So talk to them and get down to the nitty gritty.

[G.Lively]

My GP and I reached a compromise; I get a CT scan to determine if the embolism is still there.  It has been seven months since it was discovered and have been on Warfarin all of that time.  If I pass the CT scan (all clear) it will be aspirin. 

The studies I quoted are for prevention. (aspirin)  Specifically, pulmonary embolism was a part of both studies.  From what I can find, Warfarin and Aspirin both carry the same warning for kidney patients; be careful of bleeding.  More specifically, the warning was for kidney patients with a partial renal function.  Aspirin is quoted as useful for post surgery too. 

I was hallucinating and in and out of consciousness in July 2011 from renal failure. During that stay they put me on Norco for pain and was put on chemotherapy at the same rime. That continued well after release. I’m still on chemo. Months later when chest pains developed from the chronic bronchitis, the doctor who was treating me said Norco had a percussive effect and I should increase the dose.  I did, but soon two wasn’t enough.  Then that wasn’t enough and I worked up to six per day.  They just kept filling the prescription.  I found a mail order pharmacy and they sent me a three month supply.  I looked at that and questioned myself.  I stopped immediately.

Wife says my thinking was muddled, I thought I was brilliant.  Through all 800 or so posts here, I was on Norco.  Withdrawals are notoriously bad.  I would say that was an understatement.  It was like a hangover of the very worst kind times 20.  It lasted for most of two weeks without medical supervision.  For me, it was the way to go, being as impatient as I am.  Today I am coughing again and I have about 300 Norcos on the shelf where they will remain until I turn them in.  What Norco did:  fat tongue,  calm, tolerant, covered my arthritis and all my minor pains.  What withdrawals did to me:  a severe sense discomfort, extreme restlessness, diarrhea,  never hungry, dizziness, severe depression, a sense of foreboding, insomnia for days, hot flashes and cold chills, muscle twitches and a general feeling that you will probably always remember.  Worst part was five or six days.  You will feel it for another week.

I love this forum and all of the ladies who are here.  But don't sweat the small stuff, I'm 75.  Oncologist says I'm tough.  I like him too. But he is a Dodger fan - ten demerits.

[Jean]

Thanks Gerald. Like you, I am 75. My only real concern is, what happens if I stop dialysis and want stronger pain meds. Is there anything stronger? I have not and never will take more than 3 Norco a day, no matter the intensity of the pain. Just wont do it. I can get some pain relief by laying on my heated water bed. Of course, sometimes the pain is so bad, then I cant get out of the bed.  I think you were brilliant when you were posting during that era, but then, probably, your wife knows you better than I do.

[obsidianom]

Norco is basically just hydrocdone which is a moderate narctic pain med. It is a schedule 3 .  Oxycodone is a shedule 2 med and much stronger (think oxycontin or percocet) . So if you need stronger pain meds then Norco they do exist.
The studies on pulmanary embolism prophyaxis are generally for patients who have not yet thrown a dangerous embolism like you did. You are in a different catagory once you throw an embolism once. You are very high risk and it can  be very quickly lethal. Usually when someone throws an embolism it indicates some abnormality in their clotting system or other issues in the venous vascular system. That may always be there and so is the risk.
I dont like to see kidney patients on anti coagulants based on the literature either. BUT once an embolism has occurred everything changes. It is a dfficult chioice as the risk is of very rapid death if things go wrong. So be careful.
I use aspirin for the same reason , prohylactically as I have A-Fib. BUT  ------I never threw a clot or embolism. That is the differance. I dont clot quickly anyway.

[MooseMom]

I don't know anything about warfarin or pain-killers, so perhaps my reply won't be of much use to you, but my neph put me on low-dose aspirin several years ago when I was pre-D with an egfr in the mid20s.  I found that I began to bruise easily, so we cut it back to one tablet every other day.  The thinking was that since people with reduced kidney function also have high blood lipids, low dose aspirin is a good idea.  Post tx, I still take it.

[G.Lively]

Here is the final episode of the aspirin/Warfarin adventure.

GP and I exchanged words about Warfarin.  The compromise was to get a CT Scan to determine the existence of a pulmonary embolism.  Well, I showed up at the “scan your body” place where I began by asking if the “contrast” they use will harm my 35-40% kidney function.  The answer from the MD there was - - yes!  Took no test, nohow.

Lesson!  Ask questions.

Still on Warfarin.



gl

[Poppylicious]

My Blokey is on warfarin and he'll be on it for life (when they took him off he found himself back in Hospital with more blood clots) following his 'I almost died!' experience back in 2008.  I can't say whether it affected his kidney function, but he was on it before he began haemoD, whilst on haemoD and now post-transplant.  Regardless, he has no choice in the matter and he'd rather not end up in Hospital again at Death's door.

None of which really answered your question ...

 

[G.Lively]

Aspirin will prevent blood clots in many circumstances. In my case the Doctor said no aspirin unless the embolism is gone.  So, I am stuck with Warfarin since there may be no way to see if I still have that embolism.  It's a hell of a way to live life.