Efficacy and safety of low-dose aspirin on preventing transplant renal artery stenosis: a prospective randomized controlled trial
10.1097/CM9.0000000000002574
- VernacularTitle:Efficacy and safety of low-dose aspirin on preventing transplant renal artery stenosis: a prospective randomized controlled trial
- Author:
Xiangyong TIAN
1
;
Bingqing JI
;
Xiaoge NIU
;
Wenjing DUAN
;
Xiaoqiang WU
;
Guanghui CAO
;
Chan ZHANG
;
Jingge ZHAO
;
Zhiwei WANG
;
Yue GU
;
Huixia CAO
;
Tao QIN
;
Fengmin SHAO
;
Tianzhong YAN
Author Information
1. Department of Urology, Henan Provincial People’s Hospital, Henan Provincial Clinical Research Center for Kidney Disease, Zhengzhou University People’s Hospital, Henan University People’ Hospital Zhengzhou, Henan 450003, China
- Keywords:
Kidney transplantation;
Transplant renal artery stenosis;
Aspirin;
Prevention
- From:
Chinese Medical Journal
2023;136(5):541-549
- CountryChina
- Language:Chinese
-
Abstract:
Background::Transplant renal artery stenosis (TRAS) is a vascular complication after kidney transplantation associated with poor outcomes. This study aimed to analyze the efficacy and safety of low-dose aspirin for preventing TRAS.Methods::After kidney transplantation, patients were enrolled from January 2018 to December 2020 in Henan Provincial People’s Hospital. A total of 351 enrolled recipients were randomized to an aspirin group with low-dose intake of aspirin in addition to standard treatment ( n = 178), or a control group with only standard treatment ( n = 173). The patients was initially diagnosed as TRAS (id-TRAS) by Doppler ultrasound, and confirmed cases were diagnosed by DSA (c-TRAS). Results::In the aspirin and control groups, 15.7% (28/178) and 22.0% (38/173) of the recipients developed id-TRAS, respectively, with no statistical difference. However, for c-TRAS, the difference of incidence and cumulative incidence was statistically significant. The incidence of c-TRAS was lower in the aspirin group compared with the control group (2.8% [5/178] vs. 11.6% [20/173], P = 0.001). Kaplan–Meier estimates and Cox regression model identified the cumulative incidence and hazard ratio (HR) of TRAS over time in two groups, showing that recipients treated with aspirin had a significantly lower risk of c-TRAS than those who were not treated (log-rank P = 0.001, HR = 0.23, 95% confidence interval [CI]: 0.09–0.62). The levels of platelet aggregation rate ( P < 0.001), cholesterol ( P = 0.028), and low-density lipoprotein cholesterol ( P = 0.003) in the aspirin group were decreased compared with the control group in the third-month post-transplantation. For the incidence of adverse events, there was no statistical difference. Conclusion::Clinical application of low-dose aspirin after renal transplant could prevent the development of TRAS with no significant increase in adverse effects.Trial Registration::Clinicaltrials.gov, NCT04260828.
