Severe Renal Impairment
Conditions
Keywords
DESMOPRESSIN, NATIVE KIDNEY BIOPSY, SEVERE RENAL IMPAIRMENT, CHRONIC KIDNEY DISEASE
Brief summary
This study evaluated whether giving desmopressin before a native kidney biopsy reduces bleeding complications in adults with severe renal impairment (eGFR \<30 mL/min/1.73 m²). Patients undergoing kidney biopsy were enrolled sequentially into two groups: a non-desmopressin group and a desmopressin group. Patients were monitored for 24 hours after biopsy for bleeding complications, including perinephric hematoma, a decrease in hemoglobin, blood in the urine, need for blood transfusion, and other complications. The study also evaluated whether desmopressin was associated with adverse effects such as low blood sodium levels.
Detailed description
This prospective sequential cohort study evaluated the association between prophylactic intranasal desmopressin use and bleeding complications following native kidney biopsy in adults with severe renal impairment. The study was conducted at the Sindh Institute of Urology and Transplantation (SIUT), Karachi, from October 2024 to September 2025. Adults aged 18 years or older with an estimated glomerular filtration rate (eGFR) below 30 mL/min/1.73 m² who underwent native kidney biopsy for clinical indications were consecutively enrolled. Patients were sequentially enrolled into a non-desmopressin cohort from October 2024 to March 2025 and a desmopressin cohort from April 2025 to September 2025. All patients underwent ultrasound-guided kidney biopsy and were monitored clinically and by ultrasonography for 24 hours after the procedure. The study evaluated post-biopsy bleeding complications and safety outcomes, including perinephric hematoma, hemoglobin decline, gross hematuria, blood transfusion, invasive interventions, and changes in serum sodium.
Interventions
Prophylactic intranasal desmopressin acetate administered before native kidney biopsy in adults with severe renal impairment (eGFR \<30 mL/min/1.73 m²). Patients were monitored for 24 hours after biopsy for bleeding complications and safety outcomes.
OTHERNO DESMOPRESSIN
Sponsors
Sindh Institute of Urology and Transplantation
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Participants were enrolled sequentially into two cohorts: a non-desmopressin cohort from October 2024 to March 2025 and a desmopressin cohort from April 2025 to September 2025. The cohorts were compared with respect to post-biopsy bleeding and safety outcomes.
Eligibility
Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No
Inclusion criteria
Adults aged 18 years or older who provided informed consent, had an estimated glomerular filtration rate (eGFR) \<30 mL/min/1.73 m², and underwent native kidney biopsy for a clinical indication, irrespective of dialysis status. \-
Exclusion criteria
Pregnant women, kidney transplant recipients, and patients with contraindications to kidney biopsy. \-
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Overall bleeding complications after native kidney biopsy | Within 24 hours after kidney biopsy | Occurrence of any post-biopsy bleeding complication, including clinically relevant perinephric hematoma, hemoglobin decline ≥2 g/dL, persistent or clinically significant gross hematuria, or other clinically significant bleeding complications. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Perinephric hematoma >5 cm, Hemoglobin decline ≥2 g/dL, Blood transfusion requirement, Hyponatremia | Within 24 hours after kidney biopsy | Assessment of post-biopsy bleeding and safety outcomes, including perinephric hematoma \>5 cm, hemoglobin decline ≥2 g/dL, clinically significant gross hematuria, blood transfusion requirement, and other clinically significant post-biopsy complications. |
Countries
Pakistan
Outcome results
None listed