ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

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
Age50.66 (13.42)48.85 (13.83)0.32
BMI28.82 (6.2)30.72 (6.32)0.02
Serum creatinine4.02 (2.51)2.50 (1.46)0.0001
Baseline hemoglobin10.07 (1.45)11.32 (1.81)0.0001
Systolic BP135 (15)136 (16)0.6
Platelet count213.12 (71.91)239.89 (85.28)0.01
Bleeding time7.10 (2.88)4.61 (1.87)0.0001
Number of passes2.52 (0.79)2.69 (1.11)0.22
Number of glomeruli21.40 (9.66)17.92 (8.78)0.005
Mean hemoglobin decrease0.79 (0.63)0.46 (0.54)0.0001
Gross hematuria9 (11.39%)4 (3.10 %)0.0001
Post-biopsy hematoma14 (18.91%)21 (19.44%)0.90
RBC transfusion5 (6.03%)1 (0.007%)0.08