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Abstract: FR-PO899

Association of Clopidogrel Use With Renal Outcomes in US Veterans

Session Information

Category: CKD (Non-Dialysis)

  • 2201 CKD (Non-Dialysis): Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Wu, Ruoxue, University of California Irvine Medical Center, Orange, California, United States
  • Tran, Diana, University of California Irvine Medical Center, Orange, California, United States
  • Sy, John, VA Long Beach Healthcare System, Long Beach, California, United States
  • Kovesdy, Csaba P., The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Thomas, Fridtjof, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Sumida, Keiichi, The University of Tennessee Health Science Center, Memphis, Tennessee, United States
  • Kalantar-Zadeh, Kamyar, University of California Irvine Medical Center, Orange, California, United States
  • Streja, Elani, University of California Irvine Medical Center, Orange, California, United States
Background

Anti-platelet agents like clopidogrel and aspirin have traditionally been used to treat acute coronary syndrome and stroke. However, little is known about the effect on clopidogrel on long-term renal outcomes. We investigated longitudinal data to see if patients using clopidogrel without CKD have an increased risk of developing CKD and ESRD.

Methods

407,343 US veterans without CKD were divided between clopidogrel users and non-users. Cox survival models were utilized to investigate the association between clopidogrel users on with three outcomes of interest: incident CKD, incident ESRD, and death. Hazard ratios for clopidogrel users were calculated with adjustment for demographic, comorbidities, and laboratory data.

Results

Clopidogrel users were likely to be older (67.2 ± 9.9 vs 60.2 ± 12.9), male, white, with normal urine albumin levels (<30 mg/dL) and a median Charlson Comorbidity Index of 3. The risk of death was higher among clopidogrel users compared to non-users in unadjusted analysis (HR 1.71, 95% CI 1.69-1.73). Clopidogrel remained associated with CKD in unadjusted and fully adjusted models (HR: 2.24 unadjusted, 95% CI: 2.21-2.27 and HR: 1.42 fully adjusted, 95% CI: 1.40-1.45). With regards to ESRD, clopidogrel use was associated with a higher risk of incident ESRD which became insignificant in our fully adjusted model (HR: 1.79 unadjusted, 95% CI: 1.62-1.97 and HR: 1.00 fully adjusted, 95% CI: 0.88-1.14).

Conclusion

Clopidogrel use in non-CKD US veterans is associated with lower risk of mortality, and a higher risk of incident CKD but no association with ESRD.

Funding

  • NIDDK Support