No effect of desmopressin administration before kidney biopsy on the risk of major post-biopsy bleeding.

BACKGROUND/AIMS: The most important complication of kidney biopsy is bleeding, and it is unclear whether desmopressin is effective in preventing it. Thus, the study was conducted to compare post-biopsy bleeding with or without desmopressin prescription prior to percutaneous kidney biopsy. METHODS: In this single-centered, retrospective, and observational study, 3,018 adult patients who underwent kidney biopsy between January 1, 2003 and March 31, 2019 at our institute were recruited. Of these, 776 patients received desmopressin. To compare the differences in major bleeding events between patients administered and not administered with desmopressin, propensity score matching was performed. RESULTS: Before propensity score (PS) matching, it was observed that patients in the desmopressin group were significantly older (p<0.001) and had a higher blood pressure (p<0.001), higher serum creatinine (p<0.001), lower hemoglobin levels (p<0.001), and lower platelet counts (p=0.001) than those in the no-desmopressin group. Furthermore, the incidence of renal artery embolization was not significantly different between the two groups (p=0.077); however, blood transfusions occurred significantly more frequently in the desmopressin group (p<0.001). A comparison of the two groups after PS matching did not reveal any differences in the incidence of renal artery embolization (p=0.341), blood transfusion (p=0.579), and total major bleeding events (p=0.442). Furthermore, there was no difference in the incidence of perinephric hematoma on computed tomography or ultrasound (p=0.120). CONCLUSIONS: We do not recommend desmopressin administration before kidney biopsy.

No effect of desmopressin administration before kidney biopsy on the risk of major post-biopsy bleeding / Ausencia de efecto de la administración de desmopresina antes de una biopsia renal sobre el riesgo de hemorragia mayor tras la biopsia

Background/Aims: The most important complication of kidney biopsy is bleeding, and it is unclear whether desmopressin is effective in preventing it. Thus, the study was conducted to compare post-biopsy bleeding with or without desmopressin prescription prior to percutaneous kidney biopsy.MethodsIn this single-centered, retrospective, and observational study, 3,018 adult patients who underwent kidney biopsy between January 1, 2003 and March 31, 2019 at our institute were recruited. Of these, 776 patients received desmopressin. To compare the differences in major bleeding events between patients administered and not administered with desmopressin, propensity score matching was performed.ResultsBefore propensity score (PS) matching, it was observed that patients in the desmopressin group were significantly older (p<0.001) and had a higher blood pressure (p<0.001), higher serum creatinine (p<0.001), lower hemoglobin levels (p<0.001), and lower platelet counts (p=0.001) than those in the no-desmopressin group. Furthermore, the incidence of renal artery embolization was not significantly different between the two groups (p=0.077); however, blood transfusions occurred significantly more frequently in the desmopressin group (p<0.001). A comparison of the two groups after PS matching did not reveal any differences in the incidence of renal artery embolization (p=0.341), blood transfusion (p=0.579), and total major bleeding events (p=0.442). Furthermore, there was no difference in the incidence of perinephric hematoma on computed tomography or ultrasound (p=0.120).ConclusionsWe do not recommend desmopressin administration before kidney biopsy. (AU)

Antecedentes/objetivos: La complicación más importante de la biopsia renal es la hemorragia y no está claro si la desmopresina es eficaz en su prevención. Por lo tanto, el estudio se realizó para comparar la hemorragia tras una biopsia renal percutánea con o sin prescripción de desmopresina previa a esta.MétodosEn este estudio unicéntrico, retrospectivo y observacional se seleccionaron 3.018 pacientes adultos que se sometieron a una biopsia renal entre el 1 de enero de 2003 y el 31 de marzo de 2019 en nuestro instituto. De ellos, 776 pacientes recibieron desmopresina. Para comparar las diferencias en los acontecimientos de hemorragia mayor entre los pacientes que recibieron desmopresina y los que no, se realizó un emparejamiento por puntuación de propensión.ResultadosAntes del emparejamiento por puntuación de propensión, se observó que los pacientes del grupo con desmopresina tenían una edad significativamente mayor (p<0,001) y presentaban una presión arterial más alta (p<0,001), una creatinina sérica más alta (p<0,001), niveles de hemoglobina más bajos (p<0,001) y recuentos de plaquetas más bajos (p=0,001) que los del grupo sin desmopresina. Además, la incidencia de embolización de la arteria renal no fue significativamente diferente entre los 2 grupos (p=0,077); sin embargo, las transfusiones de sangre se produjeron con una frecuencia significativamente mayor en el grupo con desmopresina (p<0,001). Una comparación de los 2 grupos tras el emparejamiento por puntuación de propensión no reveló diferencias en la incidencia de embolización de la arteria renal (p=0,341), la transfusión de sangre (p=0,579) y los acontecimientos de hemorragia mayor totales (p=0,442). Además, no se observaron diferencias en la incidencia de hematomas perinéfricos en la tomografía computarizada o la ecografía (p=0,120).ConclusionesNo se recomienda la administración de desmopresina antes de una biopsia renal. (AU)

No effect of desmopressin administration before kidney biopsy on the risk of major post-biopsy bleeding.

BACKGROUND/AIMS: The most important complication of kidney biopsy is bleeding, and it is unclear whether desmopressin is effective in preventing it. Thus, the study was conducted to compare post-biopsy bleeding with or without desmopressin prescription prior to percutaneous kidney biopsy. METHODS: In this single-centered, retrospective, and observational study, 3,018 adult patients who underwent kidney biopsy between January 1, 2003 and March 31, 2019 at our institute were recruited. Of these, 776 patients received desmopressin. To compare the differences in major bleeding events between patients administered and not administered with desmopressin, propensity score matching was performed. RESULTS: Before propensity score (PS) matching, it was observed that patients in the desmopressin group were significantly older (p<0.001) and had a higher blood pressure (p<0.001), higher serum creatinine (p<0.001), lower hemoglobin levels (p<0.001), and lower platelet counts (p=0.001) than those in the no-desmopressin group. Furthermore, the incidence of renal artery embolization was not significantly different between the two groups (p=0.077); however, blood transfusions occurred significantly more frequently in the desmopressin group (p<0.001). A comparison of the two groups after PS matching did not reveal any differences in the incidence of renal artery embolization (p=0.341), blood transfusion (p=0.579), and total major bleeding events (p=0.442). Furthermore, there was no difference in the incidence of perinephric hematoma on computed tomography or ultrasound (p=0.120). CONCLUSIONS: We do not recommend desmopressin administration before kidney biopsy.