Abstract: SA-PO0684
Effect of Intravenous (IV) Desmopressin on Bleeding After Kidney Biopsy: A Seven-Year Cohort Study
Session Information
- Glomerular Diseases: Clinical, Outcomes, and Therapeutics Research - Other
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Sivakumaran, Vhinoth, Darent Valley Hospital, Dartford, England, United Kingdom
- Naseem, Zayna, Darent Valley Hospital, Dartford, England, United Kingdom
- Okunade, Oluwaseyi A., Darent Valley Hospital, Dartford, England, United Kingdom
- Mujeeb, Senan, Darent Valley Hospital, Dartford, England, United Kingdom
- Braide-Azikiwe, Dandisonba Bamidele Chinwe, Darent Valley Hospital, Dartford, England, United Kingdom
- Rathod, Jeetendra Ramesh, Darent Valley Hospital, Dartford, England, United Kingdom
Background
IV Desmopressin (DDAVP) is often given before kidney biopsy to reduce bleeding risk in patients with impaired renal function. Evidence is mixed; meta analyses suggest reductions in minor bleeding but unclear effects on clinically important outcomes. We evaluated whether prophylactic IV DDAVP reduced post biopsy bleeding events in a real world cohort with variation in renal function.
Methods
We conducted a retrospective cohort study of 267 consecutive native kidney biopsies at Darent Valley Hospital (Nov 2019–Apr 2026). IV DDAVP was given 30 minutes before the biopsy to patients with serum creatinine > 250 µmol/L. The primary outcome was rates of post biopsy bleeding. We compared rates of bleeding between patients receiving IV DDAVP (Group 1) and ones that did not (Group 2). We used Poisson regression with robust SEs to estimate adjusted risk ratios, adjusting for eGFR as a surrogate for baseline bleeding risk.
Results
The average patient age was 57 years and 51% were men. 46 (17%) received desmopressin. Mean eGFR was significantly lower in Group 1 patients (18ml/min vs 46ml/min). A higher proportion of Group 1 biopsies were urgent compared to Group 2 (53% vs 30%). The overall average number of attempts was 1.9 vs 2.3 respectively. Bleeding occurred in 5 (11%) vs 14 (6%) Group 1 vs Group 2 patients (crude RR 1.73). After adjustment for eGFR, IV DDAVP administration did not significantly reduce post kidney biopsy bleeding (aRR 1.08; 95% CI 0.42–2.31; p=0.87). There was a potential signal toward fewer clinically significant bleeding events needing blood transfusion however, comparative numbers are very small (none in Group 1 vs two in Group 2). One patient in Group 1 suffered immediate post biopsy acute non-ST elevated myocardial infarction.
Conclusion
Pre-Biopsy DDAVP did not show reduction in bleeding after adjustment for renal function. Higher risk of bleeding in patients receiving IV DDAVP may be explained by uraemia or critically unwell patients and urgency in performing biopsy. The occurrence of a probable DDAVP related NSTEMI highlights potential significant harm. Routine prophylactic use should be carefully considered; prospective studies are needed to identify subgroups with net benefit.