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Antiplatelet Agents for Chronic Kidney Disease (Review)

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Antiplatelet Agents for Chronic Kidney Disease (Review) Cochrane Library Cochrane Database of Systematic Reviews Antiplatelet agents for chronic kidney disease (Review) Razavian M, Di Micco L, Palmer SC, Craig JC, Perkovic V, Zoungas S, Webster AC, Jardine MJ, Strippoli GFM Razavian M, Di Micco L, Palmer SC, Craig JC, Perkovic V, Zoungas S, Webster AC, Jardine MJ, Strippoli GFM. Antiplatelet agents for chronic kidney disease. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD008834. DOI: 10.1002/14651858.CD008834.pub2. www.cochranelibrary.com Antiplatelet agents for chronic kidney disease (Review) Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Trusted evidence. Informed decisions. Library Better health. Cochrane Database of Systematic Reviews T A B L E O F C O N T E N T S HEADER......................................................................................................................................................................................................... 1 ABSTRACT..................................................................................................................................................................................................... 1 PLAIN LANGUAGE SUMMARY....................................................................................................................................................................... 1 BACKGROUND.............................................................................................................................................................................................. 2 OBJECTIVES.................................................................................................................................................................................................. 2 METHODS..................................................................................................................................................................................................... 2 ACKNOWLEDGEMENTS................................................................................................................................................................................ 5 REFERENCES................................................................................................................................................................................................ 6 ADDITIONAL TABLES.................................................................................................................................................................................... 8 APPENDICES................................................................................................................................................................................................. 9 CONTRIBUTIONS OF AUTHORS................................................................................................................................................................... 14 DECLARATIONS OF INTEREST..................................................................................................................................................................... 14 SOURCES OF SUPPORT............................................................................................................................................................................... 15 INDEX TERMS............................................................................................................................................................................................... 15 Antiplatelet agents for chronic kidney disease (Review) i Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Trusted evidence. Informed decisions. Library Better health. Cochrane Database of Systematic Reviews [Intervention Review] Antiplatelet agents for chronic kidney disease Mona Razavian1, Lucia Di Micco2, Suetonia C Palmer3, Jonathan C Craig4, Vlado Perkovic1, Sophia Zoungas5, Angela C Webster6, Meg J Jardine7, Giovanni FM Strippoli8 1Renal and Metabolic Division, The George Institute for International Health, Camperdown, Australia. 2Division of Nephrology, University of Naples "Federico II", Naples, Italy. 3Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 4a) Cochrane Renal Group, Centre for Kidney Research, The Children's Hospital at Westmead, b) Sydney School of Public Health, The University of Sydney, Sydney, Australia. 5Renal Division, The George Institute for International Health, Camperdown, Australia. 6(a) Cochrane Renal Group, Centre for Kidney Research, The Children's Hospital at Westmead, (b) Centre for Transplant and Renal Research, Westmead Millennium Institute, University of Sydney at Westmead Hospital, (c) Sydney School of Public Health, University of Sydney, Sydney, Australia. 7Renal Medicine, Concord Repatriation General Hospital, Concord, Australia. 8a) Mario Negri Sud Consortium, Santa Maria Imbaro (Ch), Italy, b) Sydney School of Public Health, University of Sydney, Australia, c) Diaverum Medical-Scientific OGice, Lund, Sweden Contact address: Suetonia C Palmer, Renal Division, Brigham and Women's Hospital, Harvard Medical School, Harvard Institute of Medicine, Room 550, 4 Blackfan Street, Boston, MA, 02115, USA. [email protected]. Editorial group: Cochrane Kidney and Transplant Group Publication status and date: New, published in Issue 2, 2013. Citation: Razavian M, Di Micco L, Palmer SC, Craig JC, Perkovic V, Zoungas S, Webster AC, Jardine MJ, Strippoli GFM. Antiplatelet agents for chronic kidney disease. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD008834. DOI: 10.1002/14651858.CD008834.pub2. Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. A B S T R A C T There is no abstract. The objectives are as follows: To evaluate the benefits and harms of antiplatelet therapy in patients with any form of kidney disease, including patients with CKD not receiving renal replacement therapy (RRT), patients receiving any form of dialysis, and kidney transplant recipients. P L A I N L A N G U A G E S U M M A R Y [Plain language title] [Summary text] Antiplatelet agents for chronic kidney disease (Review) 1 Copyright © 2013 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Cochrane Trusted evidence. Informed decisions. Library Better health. Cochrane Database of Systematic Reviews B A C K G R O U N D This systematic review aims to assess the relative benefits and harms of any antiplatelet agents for the prevention of Description of the condition cardiovascular disease and kidney disease progression in patients with CKD. Cardiovascular disease is the leading cause of morbidity and mortality in all stages of chronic kidney disease (CKD) (Casas 2005; O B J E C T I V E S Keith 2004; Mann 2001; Norris 2006; Sarnak 2003; Weiner 2004a; Weiner 2004b) including the CKD of renal transplant recipients To evaluate the benefits and harms of antiplatelet therapy in (US Renal Data system. 2008, Australia and New Zealand Dialysis patients with any form of kidney disease, including patients and Transplant registry (ANZDATA), (Aakhus 1999; Kasiske 2000; with CKD not receiving renal replacement therapy (RRT), patients Ojo 2000). Compared with the general population, the risk of receiving any form of dialysis, and kidney transplant recipients. cardiovascular disease is increased two-fold in early CKD (Go 2004) and 10 to 20-fold in dialysis patients (Fort 2005) in whom it accounts M E T H O D S for 50% of all deaths (Collins 2003). Population representative surveys in Australia (AusDiab Survey 2003) and United States Criteria for considering studies for this review (NHANES 2010) have shown a CKD prevalence of approximately Types of studies 16% in the adult population. With the increasing prevalence of some of the known risk factors for CKD including hypertension, We will consider for inclusion all RCTs of any antiplatelet agent obesity and diabetes (Fields 2004; Koren-Morag 2006; Mokdad in patients with CKD where the duration of follow-up was two 2003), the burden of CKD and its complications are projected months or longer. We define patients with CKD as those who are to increase and to significantly contribute to global health care receiving any form of RRT, have a functioning kidney transplant, expenditure. or have impaired kidney function defined as a reduced glomerular filtration rate (GFR < 60 mL/min/1.73 mS), the presence of other How the intervention might work markers of kidney damage such as proteinuria (KDOQI stages 1-5), an elevated serum creatinine (SCr > 120 mmol/L) or as defined Platelets play a pivotal role in thrombosis and various available by study authors. Data from CKD subgroups within studies with antiplatelet agents block platelet activation and aggregation at broader inclusion criteria (e.g. people from the general population, various points in the thrombotic cascade. Currently available data people with diabetes, people with cardiovascular disease), which suggests that antiplatelet agents might be beneficial in patients report outcomes for participants with CKD, will also be considered with CKD for primary (ATT 2002; Ruilope 2001) and secondary for inclusion. (Berger 2003; McCullough 2002) prevention of cardiovascular events. Antiplatelet agents might have beneficial eGects on the Types of participants kidney, possibly reducing proteinuria and protecting renal function in patients with glomerulonephritis (Taji
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