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

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, χ 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 <0.05 was considered significant.

Results: In NKb with creatinine >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.