Desmopressin for the prevention of bleeding in percutaneous kidney biopsy: efficacy and hyponatremia.


Journal

International urology and nephrology
ISSN: 1573-2584
Titre abrégé: Int Urol Nephrol
Pays: Netherlands
ID NLM: 0262521

Informations de publication

Date de publication:
Jun 2019
Historique:
received: 27 11 2018
accepted: 16 04 2019
pubmed: 28 4 2019
medline: 10 1 2020
entrez: 28 4 2019
Statut: ppublish

Résumé

Desmopressin is used to reduce bleeding complications for kidney biopsies with azotemia but little is known about desmopressin-induced hyponatremia in these individuals. We aimed to evaluate the impact of desmopressin prophylaxis on severe hyponatremia and bleeding after kidney biopsies in individuals with renal impairment. This is a single-center retrospective cohort study of consecutive adults with serum creatinine ≥ 150 µmol/L and had ultrasound-guided percutaneous native or transplant kidney biopsies between June 2011 and July 2015. Data were retrieved from electronic medical records. Primary outcomes were the use of desmopressin prophylaxis and severe hyponatremia (serum sodium ≤ 125 mmol/L) within 7 days post-biopsy. Secondary outcome was post-biopsy bleeding. 240 native kidney and 196 allograft biopsies were performed. Median age was 51 (IQR 42.3, 60) years and eGFR was 21.9 (12.9, 30.1) ml/min/1.73 m Pre-biopsy desmopressin was associated with severe hyponatremia in individuals with renal impairment; hence, susceptible patients given desmopressin should be closely monitored.

Sections du résumé

BACKGROUND BACKGROUND
Desmopressin is used to reduce bleeding complications for kidney biopsies with azotemia but little is known about desmopressin-induced hyponatremia in these individuals. We aimed to evaluate the impact of desmopressin prophylaxis on severe hyponatremia and bleeding after kidney biopsies in individuals with renal impairment.
METHOD METHODS
This is a single-center retrospective cohort study of consecutive adults with serum creatinine ≥ 150 µmol/L and had ultrasound-guided percutaneous native or transplant kidney biopsies between June 2011 and July 2015. Data were retrieved from electronic medical records. Primary outcomes were the use of desmopressin prophylaxis and severe hyponatremia (serum sodium ≤ 125 mmol/L) within 7 days post-biopsy. Secondary outcome was post-biopsy bleeding.
RESULTS RESULTS
240 native kidney and 196 allograft biopsies were performed. Median age was 51 (IQR 42.3, 60) years and eGFR was 21.9 (12.9, 30.1) ml/min/1.73 m
CONCLUSION CONCLUSIONS
Pre-biopsy desmopressin was associated with severe hyponatremia in individuals with renal impairment; hence, susceptible patients given desmopressin should be closely monitored.

Identifiants

pubmed: 31028561
doi: 10.1007/s11255-019-02155-9
pii: 10.1007/s11255-019-02155-9
doi:

Substances chimiques

Hemostatics 0
Deamino Arginine Vasopressin ENR1LLB0FP

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

995-1004

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Auteurs

Cynthia C Lim (CC)

Department of Renal Medicine, Singapore General Hospital, Academia Level 3, 20 College Road, Singapore, 169856, Singapore. cynthia.lim.c.w@singhealth.com.sg.

Benson Siow (B)

Pharmacy, Singapore General Hospital, 1 Hospital Drive, Outram Road, Singapore, Singapore.

Jason C J Choo (JCJ)

Department of Renal Medicine, Singapore General Hospital, Academia Level 3, 20 College Road, Singapore, 169856, Singapore.

Mayank Chawla (M)

Department of Renal Medicine, Singapore General Hospital, Academia Level 3, 20 College Road, Singapore, 169856, Singapore.

Yok Mooi Chin (YM)

Department of Renal Medicine, Singapore General Hospital, Academia Level 3, 20 College Road, Singapore, 169856, Singapore.

Terence Kee (T)

Department of Renal Medicine, Singapore General Hospital, Academia Level 3, 20 College Road, Singapore, 169856, Singapore.

Puay Hoon Lee (PH)

Pharmacy, Singapore General Hospital, 1 Hospital Drive, Outram Road, Singapore, Singapore.

Marjorie Foo (M)

Department of Renal Medicine, Singapore General Hospital, Academia Level 3, 20 College Road, Singapore, 169856, Singapore.

Chieh Suai Tan (CS)

Department of Renal Medicine, Singapore General Hospital, Academia Level 3, 20 College Road, Singapore, 169856, Singapore.

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