title: Desmopressin acetate in percutaneous ultrasound-guided kidney biopsy: a randomized controlled trial.
abstract: BACKGROUND
  Bleeding complications occur in one-third of percutaneous kidney biopsies and increase costs of the hospital stay. The aim of the study was to evaluate the effect of prebiopsy administration of desmopressin acetate versus placebo in the incidence of postbiopsy bleeding complications.
  
  
  METHODS
  Double-blind randomized controlled clinical trial.
  
  
  METHODS
  We enrolled all patients with serum creatinine level ≤1.5 mg/dL and/or estimated glomerular filtration rate ≥60 mL/min/1.73 m(2) and normal coagulation parameters undergoing ultrasound-guided biopsy of the native kidney in our unit from August 2008 to December 2009.
  
  
  METHODS
  We examined prebiopsy subcutaneous administration of desmopressin acetate, 0.3 μg/kg, compared with placebo.
  
  
  METHODS
  The primary outcome was incidence of bleeding complications. Secondary outcomes were hematoma size, postbiopsy hemoglobin level, coagulation parameters, glomerular filtration rate, blood pressure, and length of hospital stay.
  
  
  RESULTS
  162 adult patients (88 men and 74 women) were enrolled; 80 were allocated to desmopressin treatment, and 82, to the placebo group. Desmopressin compared with placebo significantly decreased the risk of postbiopsy bleeding (11 of 80 [13.7%] vs 25 of 82 [30.5%]; relative risk, 0.45; 95% CI, 0.24-0.85; P = 0.01), hematoma size (median, 208 [25th-75th percentile, 120-300] vs 380 [25th-75th percentile, 270-570] mm(2); P = 0.006] in the 36 patients who experienced bleeding, and mean hospital stay (4.9 ± 1.1 vs 5.9 ± 1.7 days; P = 0.004); postbiopsy hemoglobin levels were not affected significantly in either group.
  
  
  CONCLUSIONS
  Single-center design of the study.
  
  
  CONCLUSIONS
  Prebiopsy desmopressin administration decreases the risk of bleeding and hematoma size in patients undergoing percutaneous kidney biopsy without a cost increase.
authors.affiliation: Nephrology, Dialysis and Transplant Unit, Department of Emergency and Organ Transplantation, University of Bari, Piazza Giulio Cesare 11, Bari, Italy. c.manno@nephro.uniba.it
authors.forename: Carlo
authors.initials: C
authors.lastname: Manno
authors.forename: Carmen
authors.initials: C
authors.lastname: Bonifati
authors.forename: Diletta Domenica
authors.initials: DD
authors.lastname: Torres
authors.forename: Nicla
authors.initials: N
authors.lastname: Campobasso
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Schena
mesh_terms: D000328:Adult; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D003894:Deamino Arginine Vasopressin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006470:Hemorrhage / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D007279:Injections, Subcutaneous; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D006490:Hemostatics; D003894:Deamino Arginine Vasopressin