Desmopressin (Octostim®) before a native kidney biopsy can reduce the risk for biopsy complications in patients with impaired renal function: A pilot study

• Published in: Nephrology (Carlton, Vic.) Vic.), 2018-04, Vol.23 (4), p.366-370
• Main Authors: Peters, Björn, Hadimeri, Henrik, Mölne, Johan, Nasic, Salmir, Jensen, Gert, Stegmayr, Bernd
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Biopsy; Biopsy - adverse effects; biopsy complications; bleeding-time; Chi-Square Distribution; Creatinine; Deamino Arginine Vasopressin - administration & dosage; Desmopressin; Female; Hemorrhage - etiology; Hemorrhage - prevention & control; Hemostatics - administration & dosage; Humans; Kidney - pathology; Kidney - physiopathology; kidney biopsy; Kidney Diseases - pathology; Kidney Diseases - physiopathology; Kidneys; Logistic Models; Male; Middle Aged; Multivariate Analysis; Odds Ratio; Pilot Projects; Predictive Value of Tests; Prophylaxis; Prospective Studies; Protective Factors; Registries; renal biopsy; Renal function; Retrospective Studies; Risk Factors; Sweden; ultrasound; Urologi och njurmedicin; Urology & Nephrology; Urology and Nephrology; Young Adult
• ISSN: 1320-5358; 1440-1797; 1440-1797
• DOI: 10.1111/nep.13004

Aim To evaluate whether the administration of desmopressin alters the risk for renal biopsy complications. Methods A multicenter registry containing 576 native kidney biopsies (NKb) with a serum creatinine above 150 μmol/L in 527 patients (372 men and 155 women, median age 61 years) was used. Most of the data were prospective. At one of the hospitals all biopsies with creatinine above 150 μmol/L received desmopressin before biopsies (NKb 204). These were compared to outcome of biopsy complications against other centres where desmopressin was not given (NKb 372). Fisher's exact test, χ2 analyses, univariate and multiple binary logistic regression were used. Data were given as odds ratio (OR) and confidence interval (CI). A two sided P‐value of 150 μmol/L, those with desmopressin had less overall (3.4% vs 8.4%, OR 0.39, CI 0.17–0.90) whereas major or minor complications were not different. While desmopressin did not exhibit difference in complications in men, women received less major (0% vs 8.6%, P = 0.03) and overall complications (0% vs 12.1%, P = 0.006). A multiple logistic regression revealed that, after adjusting for BMI, age and sex, prophylaxis with desmopressin showed less major (OR 0.38, CI 0.15–0.96) and overall complications (OR 0.36, CI 0.15–0.85). Conclusion Desmopressin given before a native kidney biopsy in patients with impaired renal function can reduce the risk for complications. Summary at a Glance The study indicates that desmopressin prophylaxis prior to a native kidney biopsy in patients with a serum creatinine above 150 μmol/L reduces the risk for major and overall biopsy complications, especially in women.