Renal Effects and Peri‑operative Management of Low‑Dose Aspirin

Mechanism and Clinical Impact on Urinary Function

Low‑dose aspirin (≈ 81 mg daily) can impair renal prostaglandin synthesis, leading to reduced glomerular filtration, lower urine output, and mild fluid retention in older adults; these changes are generally modest at low doses. 1

When starting low‑dose aspirin in an older adult, baseline and follow‑up (1–2 weeks) assessment of renal function (serum creatinine, BUN) and serum uric acid is advised, because measurable changes can occur rapidly. 1

Low‑dose aspirin (75–81 mg) does not produce a clinically significant impact on blood pressure control or renal prostaglandin activity, distinguishing it from higher‑dose NSAIDs. [1][2]

For most urological interventions—including ureteroscopy—low‑dose aspirin may be continued without increased procedural risk. [3][4]
Prostate biopsy performed while on low‑dose aspirin carries roughly a one‑third higher incidence of minor bleeding, yet the procedure remains safely feasible. 3
For higher‑risk surgeries such as transurethral resection of the prostate (TURP) or percutaneous nephrolithotomy, aspirin should be discontinued pre‑operatively, with appropriate bridging anticoagulation if thrombotic risk is elevated. [3][4]