Aspirin Shows Inconclusive Results for CKD Patients
A large UK trial found no clear evidence that daily aspirin prevents first heart events in adults with chronic kidney disease.
Updated on Nov. 6, 2026 in Heart Disease
The ATTACK trial, presented at ASN Kidney Week in Denver, randomized 4,633 adults with chronic kidney disease to 75 mg aspirin or no aspirin. Researchers reported that results did not provide conclusive evidence of a reduction in first atherosclerotic cardiovascular events.
Why it matters
Chronic kidney disease is strongly linked to cardiovascular disease, so clinicians have long weighed aspirin's benefits against its bleeding risk in this group. The inconclusive findings leave that trade-off unresolved for many patients.
The trial enrolled 4,633 adults with CKD across UK primary care practices and followed them for a mean of 3.1 years. Aspirin-treated patients had a primary endpoint rate of 2.4% versus 3.3% in controls, while bleeding events were higher in the aspirin group (29 versus 19), and the analysis did not resolve whether the difference is significant.
The players
ASN Kidney Week
The American Society of Nephrology's annual meeting, where the ATTACK trial results were presented to nephrology researchers and clinicians.
The details
Patients were randomly assigned between March 2019 and December 2023 to either 75 mg aspirin or no aspirin, with 2,317 receiving aspirin and 2,316 not. Mortality was 5.4% in the aspirin group and 4.9% in the control group, and the primary end point was time to first major cardiovascular event.
Timeline
March 2019: Patient randomization began.
December 2023: Patient randomization ended.
2026: Results were presented at ASN Kidney Week in Denver, Colorado.
Health Landscape
Aspirin is established for cardiovascular prevention in the general population, but its benefits in chronic kidney disease have been unclear because bleeding risk is elevated in this group. The ATTACK trial adds a large randomized dataset to this question, yet its inconclusive outcome means future trials or meta-analyses remain necessary.
Patients with chronic kidney disease should discuss aspirin use with their clinicians, since the trial did not establish a clear benefit and bleeding risk rose in the aspirin group. Decisions remain individualized until further evidence clarifies the trade-off.
The takeaway
Aspirin's protective effect against heart events in chronic kidney disease remains unproven, so patients should weigh the bleeding risk carefully with their doctor. Watch for follow-up trials that could settle the question.
Further reading
Explore more in Heart Disease to see how kidney function shapes cardiovascular risk.
Source note: This article includes information reported by Derm Immuno Today.
