The clot-promoting drug desmopressin is commonly used with the goal of reducing bleeding complications in patients undergoing percutaneous kidney biopsy. But the evidence supporting this practice is weak—particularly in patients with decreased kidney function.
Desmopressin’s impact on bleeding risk after kidney biopsy depends on the patient’s creatinine level, reports a paper in the open-access journal BMC Nephrology (1). In a retrospective analysis, Ambarish Athavale, MD, and colleagues of Cook County Health, Chicago, report that desmopressin is associated with fewer bleeding events in patients with elevated serum creatinine—but with a spuriously increased bleeding risk in those with lower creatinine values.
“Desmopressin should not be used routinely prior to percutaneous kidney biopsy in patients at low risk for bleeding but should be reserved for patients who are at high risk for bleeding,” the researchers write.
Athavale A, et al. Desmopressin and bleeding risk after percutaneous kidney biopsy. BMC Nephrol 2019; 20:413. doi: 10.1186/s12882-019-1595-4.
Manno C, et al. Predictors of bleeding complications in percutaneous ultrasound-guided renal biopsy. Kidney Int 2004; 66:1570–1577.
Peters B, et al. Desmopressin (Octostim®) before a native kidney biopsy can reduce the risk for biopsy complications in patients with impaired renal function: a pilot study. Nephrology (Carlton) 2018; 23:366–370.
Lim CC, et al. Desmopressin for the prevention of bleeding in percutaneous kidney biopsy: efficacy and hyponatremia. Int Urol Nephrol 2019; 51:995–1004.
Moledina DG, et al. Kidney biopsy-related complications in hospitalized patients with acute kidney disease. Clin J Am Soc Nephrol 2018; 13:1633–1640.