Abstract 10863: Long-term Use of Low-dose Aspirin Develops Proteinuria in Patients With Diabetes: A Reanalysis of JPAD Study
Objectives: Low-dose aspirin therapy is widely used for preventing cardiovascular diseases (CVD) all over the world. Patients at high CVD risk take aspirin through life; however, there is little evidence for renal toxicity in long-term use of low-dose aspirin. Diabetic patients are at high risk for not only CVD, but also renal failure. We analyzed whether long-term use of low-dose aspirin affects renal function in diabetic patients.
Methods: We have conducted JPAD study to evaluate whether low-dose aspirin prevents CVD in patients with type 2 diabetes and no history of CVD. 2,536 patients were randomly assigned to the aspirin (81 or 100 mg daily) or no aspirin groups. We followed the cohort of JPAD study from May 2002 to July 2011 for a median of 7.1 years. We employed positive conversion of proteinuria as an early phenomenon of renal dysfunction, and evaluated it annually during follow-up period. We assessed the effect of aspirin on incidence of proteiuria. The analysis was performed according to the intention-to-treat principle. P values were calculated by the log-rank test.
Results: The analysis included 2,173 patients who were negative for proteinuria at baseline. Aspirin developed proteinuria in 267 patients of aspirin group (n = 1,075) and 240 patients of no aspirin group (n = 1,098). Survival analysis demonstrated that low-dose aspirin significantly increased the incidence of proteinuria (P = 0.02, Figure). The hazard ratio (95% confidence intervals) calculated by the Cox proportional hazard models was 1.22 (1.03 to 1.46). Subgroup analyses showed that the incidence of proteinuria was increased in patients aged ≥65 years (n = 1,162; P = 0.04), not in those aged <65 years (n = 1,011; P = 0.33), and unaffected by renal function at baseline (estimated GFR [ml/min/1.73m2]: ≥90, P = 0.28; 60 to 89, P = 0.09; <60, P = 0.14).
Conclusion: These results suggest that long-term use of low-dose aspirin affects renal function in patients with type 2 diabetes.
- © 2013 by American Heart Association, Inc.