Background: Desmopressin (DDAVP) is often used prior to procedures to minimize bleeding in patients with renal failure; however, there is little evidence to support this practice. The objectives of this study were to evaluate the practice of administration of DDAVP prior to procedures within our division and to determine the number of bleeding episodes for patients who received DDAVP compared to those who did not. Methods: Hospital records of patients who underwent renal biopsy or central line placement between April 2006 and March 2008 were reviewed. Patients with glomerular filtration rate (GFR) <60 ml/min/1.73 m2 were identified and subcategorized into three groups: group A GFR <15 ml/min/1.73 m2, group B GFR 15-29 ml/min/1.73 m2, and group C GFR 30-60 ml/min/1.73 m2. The number of bleeding events was noted in each group. Results: No significant difference was found in the number of bleeding events between those who received and did not receive DDAVP overall and in each GFR group. A possible trend towards the benefit with treatment in group A was observed. Conclusion: There was no significant reduction in bleeding for those who received DDAVP which questions the validity of this practice. Patients with GFR <15 ml/min/1.73 m2 may possibly derive benefit.

1.
Hedges SJ, Dehoney SB, Hooper JS, Amanzadeh J, Busti AJ: Evidence-based treatment recommendations for uremic bleeding. Nat Clin Pract Nephrol 2007;3:138-153.
2.
Mannucci PM, Remuzzi G, Pusineri F, Lombardi R, Valsecchi C, Mecca G, Zimmerman T: Deamino-8-D-arginine vasopressin shortens the bleeding time in uremia. N Engl J Med 1983;308:8-12.
3.
Franchini M: The use of desmopressin as a hemostatic agent: a concise review. Am J Hematol 2007;82:731-735.
4.
Kohler M, Hellstern P, Tarrach H, Bambauer R, Wenzel E, Jutzler GA: Subcutaneous injection of DDAVP: evaluation of new more concentrated preparation. Hemostasis 1989;19:38-44.
5.
Watson AJ, Keogh JA: Effect of 1-deamino-8-D-arginine vasopressin on the prolonged bleeding time in chronic renal failure. Nephron 1982;32:49-52.
6.
Schwartz GJ, Haycock GB, Edelmann CM Jr, Spitzer A: A simple estimate of glomerular filtration rate in children derived from body length and plasma creatinine. Pediatrics 1976;58:259-263.
7.
Rodgers RP, Levin J: A critical reappraisal of bleeding time. Semin Thromb Hemost 1990;16:1-20.
8.
Lind SE: The bleeding time does not predict surgical bleeding. Blood 1991;77:2547-2552.
9.
Greenbaum LA, Simckes AM, McKenney D, Kainer G, Nagaraj SK, Trachtman H, Alon US: Pediatric biopsy of a single native kidney. Pediatr Nephrol 2000;15:66-69.
10.
Sweeney C, Geary DF, Hebert D, Robinson L, Langlois V: Outpatient pediatric renal transplant biopsy - is it safe? Pediatr Transplant 2006;10:159-161.
11.
Hergesell O, Felten H, Andrassy K, Kühn K, Ritz E: Safety of ultrasound-guided percutaneous renal biopsy - retrospective analysis of 1,090 consecutive cases. Nephrol Dial Transplant 1998;13:975-977.
12.
Parienti JJ, Thirion M, Mégarbane B, Souweine B, Ouchikhe A, Polito A, Forel JM, Marqué S, Misset B, Airapetian N, et al; Members of the Cathedia Study Group: Femoral versus jugular venous catheterization and risk of nosocomial events in adults requiring acute renal replacement therapy: a randomized controlled trial. JAMA 2008;299:2413-2422.
13.
Cattaneo M: The use of desmopressin in open heart surgery. Haemophilia 2008;14(suppl 1):40-47.
14.
Thumfart J, Roehr CC, Kapelari K, Querfeld U, Eggert P, Müller D: Desmopressin-associated symptomatic hyponatremic hypervolemia in children. Are there predictive factors? J Urol 2005;174:294-298.
15.
Van den Hoogen MW, Verbruggen BW, Polenewen R, Hilbrands LB, Nováková IR: Use of the platelet function analyzer to minimize bleeding complications after renal biopsy. Thromb Res 2009;123:515-522.
16.
Lee HK, Kim YJ, Jeong JU, Park JS, Chi HS, Kim SB: Desmopressin improves platelet dysfunction measured by in vitro closure time in uremic patients. Nephron Clin Pract 2010;114:c248-c252.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.