Peter K. Uduagbamen^*✉ , Titilope A. Bamikefa , Adesola T. Oyelese , Shitu Abdul-Karim O , Gbemi H. Ano-Edward , Adeola A. Adeleke , Oseiga P Odafen , David O. Siden , Oluwadamilola E. Tijani , Divine-Michael Iwuh , Princess T. Adebanwi

1. Division of Nephrology and Hypertension, Department of Internal Medicine, Bowen University/Bowen University Teaching Hospital, Ogbomosho, Nigeria.
2. Division of Nephrology and Hypertension, Department of Internal Medicine, Ben Carson (Snr) School of Medicine, Babcock University/Babcock University Teaching Hospital, Ilishan-Remo, Nigeria.
3. Renal Unit, UniOsun Teaching Hospital, Oshogbo, Department of Medicine, College of Health Sciences, Osun State University, Oshogbo, Nigeria.
4. Department of Haematology and Blood Transfusion, Ben Carson (Snr) School of Medicine, Babcock University/Babcock University Teaching Hospital, Ilishan-Remo, Nigeria.
5. Division of Nephrology and Hypertension, Department of Internal Medicine, LAUTECH Teaching Hospital, Ogbomosho, Nigeria.
6. Division of Morbid Anatomy and Histopathology, Department of Pathology, Faculty of Clinical Sciences, Bowen University/Bowen University Teaching Hospital, Ogbomosho, Nigeria.

Abstract

Antiplatelet therapy used in preventing cardiovascular events in chronic kidney disease may be associated with higher risks of bleeding, low efficacy from fewer occlusive atherosclerotic disease), attenuation of the inflammatory process, and changes in the haemogram. We prospectively determined the kidney function, the haemogram, and the lipid profile of participants with and without antiplatelet therapy. The population with a mean age of 69.21 ± 11.73 years, had more women (65.88%), p=0.001. Participants' age was positively correlated with the CKD stage, p<0.001. Bleeding was more common with clopidogrel than aspirin and, less common with advancing CKD. Cardiovascular events were more common in CKD stage 5. The men had higher eGFR but lower platelet count and platelet neutrophil ratio (PNR) than the women, p=0.004, p<0.001, and p<0.001 respectively. The eGFR, bicarbonate, and HDL cholesterol were higher with versus without antiplatelets, p=0.04, p<0.001, and p=0.001 respectively. The platelet count and PNR were higher with antiplatelet therapy and with higher CKD stage, p<0.001 and p<0.001 and, p<0.001 and p<0.001 respectively. Higher platelet count (OR-0.410, 95% CI-0.02-1.04), lower uric acid levels (OR-0.550, 95% CI-0.271-0.948), higher HDL-C (OR-0.486, 95% CI-0.093-1.013), lower LDL-C (OR-0.572, 95% CI-0.082-1.002) and lower triglycerides (OR-1.274, 95% CI-0.755-1.493) were independently associated with antiplatelet therapy. The benefits of antiplatelet therapy in CKD are anchored on its anti-inflammatory, lipid-lowering, and kidney function-improving effects, these synergistically lead to lower cardiovascular events. The increased risk and consequences of bleeding, and reductions in leucocytes and erythrocytes population should be borne in mind to prevent heightening morbidity and mortality rates.

Keywords: Antiplatelet therapy, Chronic kidney disease, Bleeding, Cardiovascular events, Platelet count, Kidney function