Abstract: SA-PO625
Does Desmopressin Decrease Kidney Biopsy Bleeding Risk in Patients with CKD?
Session Information
- Pharmacology
October 27, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
- 1700 Pharmacology (PharmacoKinetics, -Dynamics, -Genomics)
Authors
- Arslan, Cagil D., John H Stroger Hospital of Cook county, Chicago, Illinois, United States
- Athavale, Ambarish, John H Stroger Hospital of Cook county, Chicago, Illinois, United States
- Okyne, Edwin, John H Stroger Hospital of Cook county, Chicago, Illinois, United States
- Hart, Peter D., John H Stroger Hospital of Cook county, Chicago, Illinois, United States
Background
Kidney biopsy, the gold standard for diagnosing kidney disease, is associated with bleeding risk. Desmopressin is routinely prescribed to improve platelet function and decrease bleeding risk of kidney biopsy. It is not known if desmopressin decreases the risk of clinically significant bleeding (defined as post-biopsy hematoma, decrease in hemoglobin or need for RBC transfusion) in patients with CKD.
Methods
Retrospective review of consecutive percutaneous kidney biopsies performed at Stroger hospital between January 2014 and March 2018. CKD was defined as eGFR < 60ml/min/1.73 m2. All biopsies were performed under real-time ultrasound guidance. Patients with bleeding time > 10 minutes were excluded from the study.
Results
323 kidney biopsies were performed during the study period of which 217 had CKD. As compared to patients who did not receive desmopressin, administration of desmopressin did not decrease the risk of post-biopsy hematoma (18.94% in desmopressin group vs 19.44% in non-desmopressin group; p = 0.90) or need for blood transfusion (p=0.08). The mean decrease in hemoglobin was statistically significant in the desmopressin group than the non-desmopressin group (0.79 g/dl vs 0.46 g/dl; p = 0.0001) but not clinically significant. Both groups had adequate number of glomeruli on biopsy.
Conclusion
Routine administration of desmopressin in patients with CKD did not reduce the risk of clinically significant post-biopsy bleeding.
Clinical features and outcomes of kidney biopsy in patients with CKD
| Desmopressin (n=88) | No Desmopressin (n=129) | P value | |
| Age | 50.66 (13.42) | 48.85 (13.83) | 0.32 |
| BMI | 28.82 (6.2) | 30.72 (6.32) | 0.02 |
| Serum creatinine | 4.02 (2.51) | 2.50 (1.46) | 0.0001 |
| Baseline hemoglobin | 10.07 (1.45) | 11.32 (1.81) | 0.0001 |
| Systolic BP | 135 (15) | 136 (16) | 0.6 |
| Platelet count | 213.12 (71.91) | 239.89 (85.28) | 0.01 |
| Bleeding time | 7.10 (2.88) | 4.61 (1.87) | 0.0001 |
| Number of passes | 2.52 (0.79) | 2.69 (1.11) | 0.22 |
| Number of glomeruli | 21.40 (9.66) | 17.92 (8.78) | 0.005 |
| Mean hemoglobin decrease | 0.79 (0.63) | 0.46 (0.54) | 0.0001 |
| Gross hematuria | 9 (11.39%) | 4 (3.10 %) | 0.0001 |
| Post-biopsy hematoma | 14 (18.91%) | 21 (19.44%) | 0.90 |
| RBC transfusion | 5 (6.03%) | 1 (0.007%) | 0.08 |