⏳for another #tweetorialERA 🥳 @HDiniz_

➡️Native kidney biopsy plays a crucial role in the diagnosis of many conditions and, while generally safe, can be associated with bleeding complications.

Would you biopsy a patient with aspirin exposure?🤔
Aspirin is one of the most widely used antiplatelet drugs worldwide - approx. 40.000 tones are produced annually worldwide. 😮

➡️Historically aspirin exposure has been considered a contraindication for percutaneous kidney biopsy. https://www.aspirin-foundation.com/history/ 
➡️But if aspirin use poses a risk factor for bleeding, even if it is small, one could argue for mandatory preprocedural withdrawal 🤔

However, the decision to stop aspirin is not risk-free. ⚖️
This is partly explained by rebound phenomena, where prothrombogenic forces (such as thromboxane synthesis) are bolstered after aspirin discontinuation.🫀

The benefit of minimizing bleeding complications must be weighed against the increased CV risk.⚖️ https://pubmed.ncbi.nlm.nih.gov/1825534/ 
Real-world data from @scotrenalbiopsy was presented in #ERAEDTA20 by @mcq_emily showing that it is safe to continue aspirin.

Also, there is an x3 increase risk of thrombosis in ~10 days if the aspirin is stopped 🤯 https://twitter.com/ERAEDTA/status/1270014236589162497?s=20
So what should we do?

#Individualize ⚖️

In patients with high cardiovascular risk, in whom the risks of suspending aspirin therapy outweigh the increase in bleeding risk, a kidney biopsy may still be performed safely, especially if it is an elective procedure.👍
A special thanks to @mic21892, who helped with the literature review and to the whole @eraedta #SoMe team.

Thank you for your time and we hope this will help you make better clinical decisions in the future😉
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