Kidney Week

Abstract: SA-PO0683

Association of Aspirin Use with Bleeding Complications After Native Kidney Biopsy

Session Information

• Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - Other
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Glomerular Diseases

• 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics

Authors

• Menez, Steven, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Steven Menez, MD

• Hu, David G., The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

David G. Hu, MS

• Thiessen Philbrook, Heather, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Heather Thiessen Philbrook

• Bitzel, Jack, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Jack Bitzel

• Srialluri, Nityasree, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Nityasree Srialluri, MD, MS

• Corona Villalobos, Celia Pamela, The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Celia Pamela Corona Villalobos, MD, MS

• Yamamoto, Yu, Yale School of Medicine, New Haven, Connecticut, United States

Yu Yamamoto, MS

• Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States

Steven G. Coca, DO, MS

• Parikh, Chirag R., The Johns Hopkins University School of Medicine, Baltimore, Maryland, United States

Chirag R. Parikh, MD, PhD, FASN

• Moledina, Dennis G., Yale School of Medicine, New Haven, Connecticut, United States

Dennis G. Moledina, MD, PhD, FASN

Background

Common bleeding complications following native kidney biopsy include a drop in hemoglobin (Hgb) and the need for packed red blood cell (pRBC) transfusion. Guidelines suggest that anti-platelet agents such as aspirin be discontinued for 7 days or longer pre-biopsy; however, the need for urgent diagnosis may necessitate kidney biopsy with shorter washout periods. We explored the association of the temporal proximity of aspirin exposure pre-biopsy with post-biopsy bleeding complications.

Methods

Across two adult patient cohorts undergoing native inpatient kidney biopsies, at the Johns Hopkins Hospital (JHH) between 2019-2025 and at Yale University Hospital between 2015-2018, we categorized aspirin exposure by last documented use pre-biopsy. Outcomes of interest included a Hgb drop within 3 days and pRBC transfusion within 7 days post-biopsy. We used logistic regression to determine the odds of these complications by timing of most recent aspirin use.

Results

In 1,327 adults across both cohorts, aspirin use within 3 days pre-biopsy was significantly associated with greater odds of Hgb drop > 1 g/dL (aOR 1.63; 95% CI 1.09-2.42) and > 2 g/dL (aOR 2.89; 95% CI 1.57-5.31) compared to no prior aspirin use within the prior year, after adjusting for pre-biopsy hemoglobin, platelet count, serum creatinine, and baseline eGFR. Such association was not observed if aspirin was discontinued within >3 days prior to kidney biopsy. However, there was no significant increase in the odds of pRBC transfusion by timing of aspirin discontinuation (aOR 1.43; 95% CI 0.85-2.40).

Conclusion

While aspirin exposure within 3 days pre-biopsy was associated with Hgb drop post-biopsy, it was not associated with the more clinically significant complication of pRBC transfusion. These risks should be discussed when consenting patients, especially when urgent biopsy diagnosis is necessary.

Funding

• NIDDK Support