Association between acetylsalicylic acid and the risk of dialysis-related infections or septicemia among incident hemodialysis patients: a nested case–control study

BMC Nephrology

Jean-Philippe Lafrance²  Louis-Philippe Laurin²  Naoual Elftouh¹  Rachel Grinker¹  Isabelle Normand¹  Hind Harrak¹ 

[1] Nephrology Unit, Maisonneuve-Rosemont Hospital Research Center, 5415, boul. de l’Assomption, Montreal (Quebec) H1T 2M4, Canada;Division of Nephrology, Maisonneuve-Rosemont Hospital, Montreal, Canada

关键词: Renal dialysis;    Registries;    Chronic;    Kidney failure;    Infections;    Epidemiology;   

Others  :  1222309
DOI  :  10.1186/s12882-015-0112-7

 received in 2015-02-17, accepted in 2015-07-17,  发布年份 2015

【 摘 要 】

Background

Vascular access-related infections and septicemia are the main causes of infections among hemodialysis patients, the majority of them caused by Staphylococcus species. Acetylsalicylic acid (ASA) has recently been reported with a probable antistaphylococcal activity. This study aimed to evaluate the effect of ASA on the risk of dialysis-related infection and septicemia among incident chronic hemodialysis patients.

Methods

In a nested case–control study, we identified 449 cases of vascular access-related infections and septicemia, and 4156 controls between 2001 and 2007 from our incident chronic hemodialysis patients’ cohort. Cases were defined as patients hospitalized with a main diagnosis of vascular access-related infection or septicemia on the discharge sheet (ICD-9 codes). Up to ten controls per case were selected by incidence density sampling and matched to cases on age, sex and follow-up time. ASA exposure was measured at the admission and categorized as: no use, low dose (80–324 mg/d), high dose (≥325 mg/d). Odds ratios (OR) for infections were estimated using multivariable conditional logistic regression analysis, adjusting for potential confounders.

Results

Compared to no use, neither dose of ASA was associated with a decreased risk of infection: low dose (OR 1.03, 95 % CI 0.82-1.28) and high dose (OR 1.30, 95 % CI 0.96-1.75). However, diabetes (OR = 1.32, 95 % CI = 1.07–1.62) and anticoagulant use (OR = 1.62, 95 % CI = 1.30–2.02) were associated with a higher risk.

Conclusion

Among hemodialysis patients, ASA use was not associated with a reduced risk of hospitalizations for dialysis-related infections or septicemia. However, ASA may remain beneficial for its cardiovascular indications.

【 授权许可】

   
2015 Harrak et al.

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