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Risk of bleeding after percutaneous native kidney biopsy in patients receiving low-dose aspirin: a single-center retrospective study

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Abstract

Background

Although discontinuation of antiplatelet agents at least 5 days before kidney biopsy is commonly recommended, the evidence behind this practice is of low level. Indeed, few non-randomized studies previously showed an equivalent risk of bleeding in patients receiving aspirin therapy.

Methods

We conducted a single center retrospective study comparing the risk of complications after percutaneous native kidney biopsy in patients who received low-dose aspirin (ASA) within 5 days from biopsy and those who did not. The main outcome was the difference in the incidence of major complications (red blood cell transfusion, need for selective arterial embolization, surgery, nephrectomy). Secondary outcomes included difference in minor complications, comparison between patients who received ASA within 48 h or within 3–5 days, identification of independent factors predictive of major complications.

Results

We analyzed data on 750 patients, of whom 94 received ASA within 5 days from biopsy. There were no significant differences in the proportion of major complications in patients receiving or not receiving ASA (2.59% and 3.19%, respectively, percentage point difference 1%, 95% CI − 3 to 4%, p = 0.74). Groups were also comparable for minor complications; among patients receiving ASA, there were no differences in major bleeding between those who received ASA within 48 h or 3–5 days from biopsy. Significant baseline predictors of major bleeding in our cohort were platelet count lower than 120*103/microliter, higher diastolic blood pressure and higher blood urea.

Conclusions

Treatment with low-dose ASA within 5 days from kidney biopsy did not increase the risk of complications after the procedure.

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Acknowledgements

The study was approved by the local Ethical Committee “Comitato Etico dell’Area Vasta Emilia Nord”.

Funding

No funding was required for the present study.

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Authors and Affiliations

  1. Nephrology, Dialysis and Kidney Transplant Unit, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy

    Francesco Fontana, Francesco Giaroni, Gaetano Alfano, Giacomo Mori, Riccardo Magistroni & Gabriele Donati

  2. Nephrology and Dialysis Unit, Ospedale Ramazzini di Carpi, Azienda Unità Sanitaria Locale di Modena, Modena, Italy

    Silvia Cazzato

  3. Surgical, Medical and Dental Department of Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy

    Silvia Cazzato, Francesco Giaroni, Fabrizio Bertolini, Silvia Giovanella, Giulia Ligabue, Riccardo Magistroni, Gianni Cappelli & Gabriele Donati

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  1. Francesco Fontana
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Contributions

FF conceived and designed the study; SC, FG, FB, SG, GL collected the data; FF and GA analyzed the data; FF wrote the manuscript; GM, RM, GC, GD critically revised the manuscript.

Corresponding author

Correspondence to Francesco Fontana.

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Conflict of interest

The Authors declare no conflict of interest for the present study; the results presented in this paper have not been published previously in whole or part, except in abstract format.

Ethics approval

The study was approved by the appropriate institutional research ethics committee (“Comitato Etico dell’Area Vasta Emilia Nord”) and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Fontana, F., Cazzato, S., Giaroni, F. et al. Risk of bleeding after percutaneous native kidney biopsy in patients receiving low-dose aspirin: a single-center retrospective study. J Nephrol 36, 475–483 (2023). https://doi.org/10.1007/s40620-022-01441-7

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  • DOI: https://doi.org/10.1007/s40620-022-01441-7

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