“To take or not to take an aspirin?” The age-old question of cardiovascular disease primary prevention for people with chronic kidney disease

Despite the higher risk of cardiovascular events in patients with chronic kidney disease, the role of aspirin for primary prevention is unclear. In the current issue, Wolfe et al. present a subgroup analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) trial that suggests there was no reduction in cardiovascular events but bleeding events were doubled. Aspirin cannot be recommended for primary prevention in chronic kidney disease, but the continuation of ongoing research, such as the Aspirin To Target Arterial Events in Chronic Kidney Disease (ATTACK trial), is warranted.