The Role of Fixed-Dose Desmopressin in Hemostatic Outcomes of Native and Transplant Kidney Biopsies in a Tertiary Referral Hospital

Introduction/Objectives: Although desmopressin is commonly used to reduce bleeding hazards in patients undergoing kidney biopsies, its effectiveness varies among individuals. This study aims to assess the impact of desmopressin on bleeding risk and hemodynamic stability in patients undergoing kidney biopsies while also identifying potential risk factors influencing these outcomes. Methods: A retrospective study was conducted at King Abdulaziz Medical City to evaluate adult patients who underwent either native or transplant kidney biopsies. The collected data included demographics, comorbidities, demographics, desmopressin usage, vital signs, lab results, and bleeding events. Bleeding was defined as a composite outcome encompassing both minor and major bleeding. Results: Data from 210 patients who received desmopressin during kidney biopsies were analyzed alongside 200 control patients. The distribution of gender and age was comparable between the two groups. However, the types of biopsies differed significantly, with a greater number of native kidney biopsies in the desmopressin group. Desmopressin was associated with a reduced incidence of major bleeding and shorter hospital stays. Longitudinal analyses revealed significant time-dependent changes in mean arterial pressure, hemoglobin, and hematocrit, although no treatment effect was observed. Logistic regression showed no significant impact of desmopressin on composite bleeding, hypotension, or hyponatremia, though comorbidities and transplant biopsies were associated with a reduced risk of hyponatremia. Conclusions: Desmopressin was associated with fewer episodes of major bleeding and shorter hospital stays but had no direct effect on hemodynamic parameters. Nevertheless, further research is necessary to explore its long-term clinical impact.