How long do you recommend patients hold aspirin for prior to and after undergoing a native kidney biopsy?

I usually recommend that patients hold aspirin (ASA) 7 days prior to and one day after undergoing a percutaneous native kidney biopsy. 30 mg of ASA irreversibly inhibits cyclooxygenase a key platelet enzyme for the synthesis of thromboxane and the effect lasts for approximately one week. This effect can be reversed by the generation of new platelets whose life span is typically 10 days. The Society of Interventional Radiology recommends stopping ASA use 5 days prior to a biopsy (Patel et al., PMID 22513394). A recent systematic review and meta-analysis did not find a significantly increased risk of major bleeding complications in ASA-exposed patients (Relvas et al, PMID 36951435). They concluded that in patients awaiting a percutaneous kidn...