Aspirin Use Associated with Improved Arteriovenous Fistula Survival

[Zach]

As always, consult you doctor.
 

Consistent Aspirin Use Associated with Improved Arteriovenous Fistula Survival among Incident Hemodialysis Patients in the Dialysis Outcomes and Practice Patterns Study

Takeshi Hasegawa*,,, Stacey J. Elder, Jennifer L. Bragg-Gresham, Ronald L Pisoni, Shin Yamazaki, Tadao Akizawa||, Michel Jadoul¶, Rayner C. Hugh**, Friedrich K Port, and Shunichi Fukuhara
* Division of Nephrology, Fujiyoshida Municipal Hospital, Yamanashi, Japan;  Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan;  Division of Nephrology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Japan;  Arbor Research Collaborative for Health, Ann Arbor, Michigan; || Division of Nephrology, Showa University School of Medicine, Tokyo, Japan; ¶ Université Catholique de Louvain, Cliniques Universitaires St-Luc, Bruxelles, Belgium; and ** Department of Renal Medicine, Birmingham Heartlands Hospital, Birmingham, United Kingdom

Correspondence: Dr. Takeshi Hasegawa, Department of Epidemiology and Healthcare Research, Kyoto University Graduate School of Medicine and Public Health, Konoe-cho Yoshida, Sakyo-ku, Kyoto, 606-8501, Japan. Phone: 81-75-753-4646; Fax: 81-75-753-4644; Email: tahasegawa-npr@umin.net

Background and objectives: The relationship between aspirin use and arteriovenous fistula (AVF) survival has been lacking. The aim of this study was to evaluate the association between AVF survival and aspirin use.

Design, setting, participants, & measurements: Data on 2815 incident hemodialysis patients (on dialysis  30 d) using an AVF at enrollment into the Dialysis Outcomes and Practice Patterns Study between 1996 and 2004 were analyzed. Cox regression was used to examine the association between aspirin use and the risk of final AVF failure, first AVF failure, and a gastrointestinal bleeding event. Aspirin use was determined at baseline and one year later. Patients using aspirin at baseline and one year later were considered consistent aspirin users. All models accounted for facility clustering effects and were adjusted for age, race, gender, body mass index, prior permanent access failure, prior placement of a catheter, 10 comorbid conditions, laboratory data, and other medications, and stratified by regions.

Results: Consistent aspirin use was significantly related to a lower risk of final AVF failure. Facility-level analysis, which may reduce confounding by indication, also showed a nearly significant trend of reduced risk of final AVF failure with greater prevalence of consistent aspirin use within dialysis facilities (P for trend = 0.07). The occurrence of a new gastrointestinal bleeding event during the study period was not associated with aspirin use.

Conclusions: These results suggest that consistent aspirin use may be beneficial for AVF survival among incident hemodialysis patients.

http://cjasn.asnjournals.org/cgi/content/abstract/3/5/1373

[flip]

Very interesting, Zach. My doc says no aspirin for some reason.

[glitter]

Does anyone here take asprin for these reasons? 

[Rerun]

I was taking a baby aspirin because my vascular surgeon told me to but then I would have a hard time stopping the bleeding at dialysis so I quit.

[flip]

I understand the logic....the thinner the blood the better it is for the fistula. I'm sure aspirin plus heparin would cause some bleeding problems. I'm wondering if the aspirin would filter out during the dialysis process.

[Wallyz]

I remembered this from a while back:

http://kidneydiseases.about.com/b/2007/03/30/aspirin-protects-dialysis-patients-from-staph-infection.htm

Researchers recently published results suggesting that aspirin use may cut the risk of Staphylococcus aureus (S. aureus) infections associated with hemodialysis catheters. They retrospectively looked at 4,722 blood cultures from 872 patients and they found that S. aureus infections were less common in patients receiving aspirin as compared to those not receiving it (a 54% decrease). Those taking a higher dose (325 mg) appeared to be more protected than those taking a reduced dose (81 mg).

[monrein]

I've always been told no aspirin, only Tylenol but that might have had to do with the transplant.  Last time I was on D I remember the no aspirin thing too but we used quite a bit more heparin in those days as I recall.

My husband used to take daily aspirin for heart health reasons, until on  a canoe trip once he had a leech attach to his leg.  When he removed it, he didn't stop bleeding for about five hours. 

[lola]

No aspirin for Otto due to transplant

[petey]

No aspirin for Marvin since 1987 -- he also has ITP (low platelets), and aspirin further complicates this disease (low platelets = longer clotting time, and aspirin thins blood even more).

[G-Ma]

I can't take asperin since my gastric bypass and bleeding ulcers but it probably would help the blood flow better, although today I did NOT have that problem..it was too free flowing.

[charee]

my dr has put me on asprin 100mg a day i don't have any problems with bleeding after i pull the needles

[flip]

We have a couple of patients on low dose aspirin for cardiac problems. They get reduced doses of heparin during dialysis.

[BigSky]

Been told to take  aspirin shortly after my fistula was put in this go around.

[jbeany]

I'm on aspirin because it helps my retinopathy.  They tried to take me off it when I started dialysis, because I was bleeding for a really long time, but my eye doc wasn't budging.  Health over convenience!