The American Diabetes Association recommend low-dose aspirin for adults with diabetes who have no previous history of vascular disease, a 10-year risk of CVD events that is greater than 10%, and no increased risk of bleeding. Several potential mechanisms have been proposed for the increased risk of CVD in Thiamine chloride patients with CKD, including increased oxidative stress, inflammation, platelet dysfunction, accelerated atherosclerosis, and attenuated response to antiplatelet agents. Similar to diabetes, CKD has recently been considered to be equivalent to coronary artery disease. Although antiplatelet agents have been shown to reduce the risk for major CVD events in patients with coronary artery disease and in those with an equivalent disease such as diabetes, limited data exist regarding the use of antiplatelet agents in patients with CKD. This is largely because these patients were systematically excluded from large randomized trials. Additionally, there is concern over whether chronic aspirin use can potentially lead to an increased risk of hemorrhage after treatment with an antiplatelet agent, as patients with CKD have abnormal platelet function. There is substantial uncertainty regarding the risk/benefit balance associated with the use of antiplatelet agents by CKD patients. Accordingly, the purpose of this study was to evaluate the effects and safety of low-dose aspirin used for the prevention of CVD in patients with CKD, a group that is at high risk for CVD. The primary end point was the development of any atherosclerotic event, which was a composite of significant coronary artery disease that required angioplasty, ischemic stroke, and peripheral vascular disease. Adverse events that were defined as composite bleeding included gastrointestinal bleeding, hemorrhagic stroke, and hemoptysis. Other secondary endpoints included death from any cause, time to doubling of serum SB-649868 creatinine, and renal failure that was defined by the occurrence of end-stage renal disease that required renal replacement therapy.Comparisons of outcome end points were performed on the basis of time until the first event according to the intention-to-treat principle, and they included all patients in the groups to which they were assigned.