Examining the impact of aspirin on patients with chronic kidney disease; a systematic review and meta-analysis

Introduction: Chronic kidney disease (CKD) poses a significant global health burden, and the efficacy and safety of aspirin in CKD patients have yielded conflicting results. Thus, our study aims to investigate the impact of aspirin consumption on individuals with CKD. Materials and Methods: This comprehensive systematic review and meta-analysis involved searching PubMed, ProQuest, Web of Science, Cochrane, and Google Scholar databases without any time restrictions until December 22, 2023. Data analysis was conducted using STATA 14 software, with a significance level set at P<0.05. Results: Our analysis encompassed 12 studies involving a total of 92,271 participants. The findings revealed no meaningfully significant relationship between aspirin administration (≤200 mg) and renal failure in these patients (OR: 0.99, 95% CI: 0.86, 1.14). Similarly, the use of low-dose aspirin (≤100 mg) did not impact renal failure in CKD patients (OR: 0.97, 95% CI: 0.81, 1.15). The association between aspirin administration and renal failure in CKD patients aged 50-59 years (OR: 1.11, 95% CI: 0.91, 1.34) and 60-69 years (OR: 0.96, 95% CI: 0.80, 1.15) was not statistically significant. However, aspirin use in CKD patients aged 70-79 demonstrated a reduction in renal failure (OR: 0.34, 95% CI: 0.14, 0.82). Furthermore, there was no statistically significant association between aspirin administration and all-cause death in CKD patients (OR: 0.96, 95% CI: 0.81, 1.13). Conclusion: Our findings suggest that aspirin consumption does not pose a risk for renal failure or all-cause mortality in CKD individuals. Registration: This study has been compiled based on the PRISMA checklist, and its protocol was registered on the PROSPERO (ID: CRD42024497581) and Research Registry (UIN: reviewregistry1768) website.