Efeitos da aspirina nas complicações hemorrágicas da biópsia renal - uma revisão sistemática

Abstract

Background: Kidney biopsies play a crucial role in diagnosing many renal conditions in native and transplanted kidneys. Despite considered safe procedures, the risk of bleeding is one of the main concerns - the use of antiaggregants can add to this risk. Due to aspirins' widespread use, the authors aimed to establish the best pre-procedural strategy regarding its cessation in patients proposed for kidney biopsy. Methods: The authors conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two electronic databases were used (MEDLINE and SCOPUS). The defined search criteria were coded into queries specific to each database. Due to significant heterogeneity in methodology, participant selection, and reported outcome measures, results were presented qualitatively. Results: Ten studies were selected, including 21624 biopsies in total. One study reviewing allograft kidney biopsies suggested high-dose aspirin within three days of the biopsy was associated with an increased risk of bleeding, and another reported higher bleeding rates in aspirin-treated patients. One study pertaining to native kidney biopsies described a higher risk of minor bleeding complications in patients under concurrent aspirin use. None of the other selected articles found an association between aspirin exposure and bleeding risk. Conclusion: This systematic review suggests that aspirin therapy is not associated with renal biopsy major bleeding complications or related death. In patients with high cardiovascular risk, in whom the risks of suspending aspirin therapy outweigh the bleeding risk, a kidney biopsy may still be performed relatively safely.