The Role of Desmopressin in Kidney Biopsies: A Narrative Review

Desmopressin is a vasopressin analogue. In addition to its antidiuretic effects, it is also a procoagulant. While it is indicated to reduce bleeding in a variety of situations, it is not currently being utilized broadly for kidney biopsies, a procedure where bleeding is the most common complication. Purpose of Review: To discuss the evidence surrounding use of desmopressin for kidney biopsy. Sources of information: We conducted a search of MEDLINE (Ovid), Embase (Ovid), CENTRAL (Wiley), International Pharmaceutical Abstracts (Ovid), and Scopus databases. Methods: All identified trials were reviewed. Trials since the last systematic review in 2020 were organized in color-coded tables by efficacy, neutral results, or harm. Key Findings: Studies are generally favorable in terms of efficacy data for reduced bleeding during kidney biopsies, with some safety concerns. More studies are still needed, but we believe desmopressin can be justified to reduce bleeding complications of kidney biopsy in the setting of chronic kidney disease (CKD). Limitations: Trials involved small sample sizes, single-center data, and were largely observational in nature.