Aspirin resistance and its related factors in patients with stage 3-4 chronic kidney disease

Abstract

Objective To investigate aspirin resistance (AR) and its related factors in patients with stage 3-4 chronic kidney disease(CKD). Methods The clinical data of 108 patients with stage 3-4 CKD from nephrology department in Beijing Chaoyang Hospital were collected (CKD group); and 110 age and sex-matched subjects with normal renal function served as control group. Anthropometric parameters, blood biochemistry index, ultrasonography and thromboelastograph (TEG) were examined in both groups; and inhibition ratio of arachidonic acid>50% on TEG was defined as AR. Results The incidence of cardio-cerebral vascular disease, the incidence of peripheral vascular disease, ratio of female, the intima-media thickness (IMT) of carotid artery, the levels of high-sensitive C-reactive protein(hsCRP), homocysteine(Hcy), evaluated glomerular filtration rate(eGFR) and maximal thrombelastodegree (MA) on TEG in CKD group were significantly higher than those in control group (all P<0.05), while R value was significantly lower in CKD group. Pearson's correlation analysis revealed that the levels of MA, hsCRP, Hcy, IMT were positively correlated and R value was negatively correlated with eGFR in CKD group. The incidence of AR in CKD group (32.4%) was significantly higher than in control group (20.0%). According to TEG, the patients were divided into AR group (n=35) and aspirin sensitive (AS) group (n=73). The incidence of cardio-cerebral vascular disease, the incidence of peripheral vascular disease, ratio of female, IMT, ratio of diabetes, the levels of hsCRP, Hcy, fasting plasma glucose (FBG), eGFR and MA in AR group were significantly higher than those in AS group (all P<0.05), while R value was significantly lower in AR group. Binary logistic regressive analysis revealed that the ratio of diabete, FBG, eGFR, hsCRP were independent risk factors for AR in patients with stage 3-4 CKD. Conclusions CKD stage 3-4 is associated with increased ratio of platelet activation and atherosclerosis, and this condition is aggravated while eGFR declining. Incidence of AR is 32.4% in this group of CKD patients, the independent risk factors of AR in CKD patients are the ratio of diabetes, FBG, eGFR and hsCRP. Key words: Chronic kidney disease; Aspirin resistance; Risk factors