Latest episode of @freelyfiltered.bsky.social is live! This one on the two RCTs of DDAVP to prevent renal biopsy bleeding. We had special guest Vandana Niyyar join us. @medpeedskidneys.bsky.social @captainchloride.bsky.social
www.nephjc.com/freelyfilter...
www.nephjc.com/freelyfilter...
FF 82 DDAVP up the nose to prevent biopsy bleeding — NephJC
Nasal DDAVP to prevent bleeding complications from renal biopsy, the results of two randoized, placebo controlled, trials.
www.nephjc.com
August 8, 2025 at 3:13 PM
Latest episode of @freelyfiltered.bsky.social is live! This one on the two RCTs of DDAVP to prevent renal biopsy bleeding. We had special guest Vandana Niyyar join us. @medpeedskidneys.bsky.social @captainchloride.bsky.social
www.nephjc.com/freelyfilter...
www.nephjc.com/freelyfilter...
Have a patient with DDAVP induced hyponatremia? I know every neuron in your brain says stop the DDAVP, but don't! Terrible outcomes from rapid correction of hyponatremia with that strategy.
academic.oup.com/ndt/article/...
academic.oup.com/ndt/article/...
September 13, 2025 at 2:33 PM
Have a patient with DDAVP induced hyponatremia? I know every neuron in your brain says stop the DDAVP, but don't! Terrible outcomes from rapid correction of hyponatremia with that strategy.
academic.oup.com/ndt/article/...
academic.oup.com/ndt/article/...
Join us tonite 5/13/25 9pm EST only on #Bluesky #NephSky #NephJC
We are discussing 2 studies on the use of desmopressin/ddAVP prophylactically to prevent post kidney biopsy bleeding.
Biopsy Blood🩸, ddAVP Sweat💦 and Nephrologist Tears😢
www.nephjc.com/news/ddavp
We are discussing 2 studies on the use of desmopressin/ddAVP prophylactically to prevent post kidney biopsy bleeding.
Biopsy Blood🩸, ddAVP Sweat💦 and Nephrologist Tears😢
www.nephjc.com/news/ddavp
Double Trouble: ddAVP and the Bleeding Biopsy — NephJC
This week, we will discuss a double header: two single centre ddAVP trials in kidney biopsy from India.
www.nephjc.com
May 13, 2025 at 10:55 AM
Join us tonite 5/13/25 9pm EST only on #Bluesky #NephSky #NephJC
We are discussing 2 studies on the use of desmopressin/ddAVP prophylactically to prevent post kidney biopsy bleeding.
Biopsy Blood🩸, ddAVP Sweat💦 and Nephrologist Tears😢
www.nephjc.com/news/ddavp
We are discussing 2 studies on the use of desmopressin/ddAVP prophylactically to prevent post kidney biopsy bleeding.
Biopsy Blood🩸, ddAVP Sweat💦 and Nephrologist Tears😢
www.nephjc.com/news/ddavp
5. Consider proactive DDAVP use
For patients at high risk of rapid overcorrection - the classic hypovolemic patient is a great example - I love a proactive DDAVP strategy (rather than reactive) 🤝
Beautifully explained in this classic @PulmCrit post: emcrit.org/pulmcrit/tak...
For patients at high risk of rapid overcorrection - the classic hypovolemic patient is a great example - I love a proactive DDAVP strategy (rather than reactive) 🤝
Beautifully explained in this classic @PulmCrit post: emcrit.org/pulmcrit/tak...
Taking control of severe hyponatremia with DDAVP
. Introduction with a case . Imagine an elderly patient presenting with hypovolemic hyponatremia (sodium of 115 mM) and moderate confusion. How would you
emcrit.org
January 24, 2025 at 2:04 PM
5. Consider proactive DDAVP use
For patients at high risk of rapid overcorrection - the classic hypovolemic patient is a great example - I love a proactive DDAVP strategy (rather than reactive) 🤝
Beautifully explained in this classic @PulmCrit post: emcrit.org/pulmcrit/tak...
For patients at high risk of rapid overcorrection - the classic hypovolemic patient is a great example - I love a proactive DDAVP strategy (rather than reactive) 🤝
Beautifully explained in this classic @PulmCrit post: emcrit.org/pulmcrit/tak...
May 14, 2025 at 1:00 AM
Check the insightful #NephJC summary by @nephroseeker.medsky.social, @dramiliflores.bsky.social, @sayalibthakare.bsky.social
http://www.nephjc.co...
http://www.nephjc.co...
Double Trouble: ddAVP and the Bleeding Biopsy — NephJC
This week, we will discuss a double header: two single centre ddAVP trials
in kidney biopsy from India.
www.nephjc.com
May 14, 2025 at 1:04 AM
Check the insightful #NephJC summary by @nephroseeker.medsky.social, @dramiliflores.bsky.social, @sayalibthakare.bsky.social
http://www.nephjc.co...
http://www.nephjc.co...
DDAVP 0.3-0.4 mcg/kg IV ↑ VWF & factor VIII release. VWF binds GPIIb-IIIa receptor on platelets, causing aggregation = antiplatelet reversal.
DDAVP ↑ platelet function in patients on antiplatelet like P2Y12i (PMIDs: 18068065,1434725,8330156)
#medsky #EMsky #pharmsky #HMsky
DDAVP ↑ platelet function in patients on antiplatelet like P2Y12i (PMIDs: 18068065,1434725,8330156)
#medsky #EMsky #pharmsky #HMsky
December 5, 2024 at 2:23 AM
Pulled up the IBCC from @pulmcrit.bsky.social for several things to show the team (hypertriG pancreatitis, DAH work up, DDAVP clamp, etc) and my residents are like what is this magic website 🤩
February 6, 2025 at 12:58 AM
Pulled up the IBCC from @pulmcrit.bsky.social for several things to show the team (hypertriG pancreatitis, DAH work up, DDAVP clamp, etc) and my residents are like what is this magic website 🤩
Our #NephJC summary double header is live
www.nephjc.com/news/ddavp
Is DDAVP any use before a kidney biopsy?
Excellent writing from @sayalibthakare.bsky.social @dramiliflores.bsky.social & @nephroseeker.medsky.social
www.nephjc.com/news/ddavp
Is DDAVP any use before a kidney biopsy?
Excellent writing from @sayalibthakare.bsky.social @dramiliflores.bsky.social & @nephroseeker.medsky.social
Double Trouble: ddAVP and the Bleeding Biopsy — NephJC
This week, we will discuss a double header: two single centre ddAVP trials in kidney biopsy from India.
www.nephjc.com
May 13, 2025 at 10:14 AM
Our #NephJC summary double header is live
www.nephjc.com/news/ddavp
Is DDAVP any use before a kidney biopsy?
Excellent writing from @sayalibthakare.bsky.social @dramiliflores.bsky.social & @nephroseeker.medsky.social
www.nephjc.com/news/ddavp
Is DDAVP any use before a kidney biopsy?
Excellent writing from @sayalibthakare.bsky.social @dramiliflores.bsky.social & @nephroseeker.medsky.social
DDAVP and high-dose NSAID?
April 1, 2025 at 7:20 PM
DDAVP and high-dose NSAID?
Proactive vs Reactive DDAVP: The Clamp Finally Faces an RCT
Thank you Thai Air Force for doing the trials that need to be done!
pbfluids.com/2026/03/proa...
Thank you Thai Air Force for doing the trials that need to be done!
pbfluids.com/2026/03/proa...
March 12, 2026 at 2:27 AM
Proactive vs Reactive DDAVP: The Clamp Finally Faces an RCT
Thank you Thai Air Force for doing the trials that need to be done!
pbfluids.com/2026/03/proa...
Thank you Thai Air Force for doing the trials that need to be done!
pbfluids.com/2026/03/proa...
📍Different inclusion = different risk profiles.
Are we really comparing DDAVP performance—or just patient selection? Nice info @nephroseeker.medsky.social #NephJC
Are we really comparing DDAVP performance—or just patient selection? Nice info @nephroseeker.medsky.social #NephJC
May 14, 2025 at 1:17 AM
📍Different inclusion = different risk profiles.
Are we really comparing DDAVP performance—or just patient selection? Nice info @nephroseeker.medsky.social #NephJC
Are we really comparing DDAVP performance—or just patient selection? Nice info @nephroseeker.medsky.social #NephJC
1/10
Last #NephJC we discussed the role of prophylactic DDAVP for preventing post kidney biopsy (KBx) bleed #TenPostNephJC .
The articles 👇
@kireports.bsky.social @asnpublications.bsky.social @jeyakumarmeyyappan.bsky.social
www.kireports.org/article/S246...
pubmed.ncbi.nlm.nih.gov/40067357/
Last #NephJC we discussed the role of prophylactic DDAVP for preventing post kidney biopsy (KBx) bleed #TenPostNephJC .
The articles 👇
@kireports.bsky.social @asnpublications.bsky.social @jeyakumarmeyyappan.bsky.social
www.kireports.org/article/S246...
pubmed.ncbi.nlm.nih.gov/40067357/
May 22, 2025 at 2:24 AM
1/10
Last #NephJC we discussed the role of prophylactic DDAVP for preventing post kidney biopsy (KBx) bleed #TenPostNephJC .
The articles 👇
@kireports.bsky.social @asnpublications.bsky.social @jeyakumarmeyyappan.bsky.social
www.kireports.org/article/S246...
pubmed.ncbi.nlm.nih.gov/40067357/
Last #NephJC we discussed the role of prophylactic DDAVP for preventing post kidney biopsy (KBx) bleed #TenPostNephJC .
The articles 👇
@kireports.bsky.social @asnpublications.bsky.social @jeyakumarmeyyappan.bsky.social
www.kireports.org/article/S246...
pubmed.ncbi.nlm.nih.gov/40067357/
- TTKG
- 24 hour urine collections instead of ACR/PCR
(maybe we should move into that for stones also)
- calculating TBW and formulae for hyponatremia correction versus just giving 3% with ddAVP 🗜️
- 24 hour urine collections instead of ACR/PCR
(maybe we should move into that for stones also)
- calculating TBW and formulae for hyponatremia correction versus just giving 3% with ddAVP 🗜️
January 23, 2025 at 3:08 PM
- TTKG
- 24 hour urine collections instead of ACR/PCR
(maybe we should move into that for stones also)
- calculating TBW and formulae for hyponatremia correction versus just giving 3% with ddAVP 🗜️
- 24 hour urine collections instead of ACR/PCR
(maybe we should move into that for stones also)
- calculating TBW and formulae for hyponatremia correction versus just giving 3% with ddAVP 🗜️
Limitations 🧩
⚠️ No p-value for interaction in subgroup
⚠️ DDAVP dosing differed
⚠️ Procedural variability (needle size, operators, passes) may confound bleeding outcomes
⚠️ Neither trial defined an “ideal” DDAVP candidate
#NephJC
⚠️ No p-value for interaction in subgroup
⚠️ DDAVP dosing differed
⚠️ Procedural variability (needle size, operators, passes) may confound bleeding outcomes
⚠️ Neither trial defined an “ideal” DDAVP candidate
#NephJC
May 14, 2025 at 1:49 AM
Limitations 🧩
⚠️ No p-value for interaction in subgroup
⚠️ DDAVP dosing differed
⚠️ Procedural variability (needle size, operators, passes) may confound bleeding outcomes
⚠️ Neither trial defined an “ideal” DDAVP candidate
#NephJC
⚠️ No p-value for interaction in subgroup
⚠️ DDAVP dosing differed
⚠️ Procedural variability (needle size, operators, passes) may confound bleeding outcomes
⚠️ Neither trial defined an “ideal” DDAVP candidate
#NephJC
Iron deficiency is difficult to treat without managing the primary issue. HMB can be treated with hormonal options (combined oral contraceptives or progesterone only options), or hemostatic agents (antifibrinolytics such as lysteda or amicar, DDAVP or factor products).
12/n
12/n
November 8, 2024 at 8:33 PM
Iron deficiency is difficult to treat without managing the primary issue. HMB can be treated with hormonal options (combined oral contraceptives or progesterone only options), or hemostatic agents (antifibrinolytics such as lysteda or amicar, DDAVP or factor products).
12/n
12/n
However, there is not consistent data to support this. Antifibrinolytics or DDAVP can be used to prevent excessive bleeding with insertion.
Expulsion is associated with high flow so controlling the first few periods (with the above) can be helpful to avoid this!
10/n
Expulsion is associated with high flow so controlling the first few periods (with the above) can be helpful to avoid this!
10/n
November 12, 2024 at 1:13 AM
However, there is not consistent data to support this. Antifibrinolytics or DDAVP can be used to prevent excessive bleeding with insertion.
Expulsion is associated with high flow so controlling the first few periods (with the above) can be helpful to avoid this!
10/n
Expulsion is associated with high flow so controlling the first few periods (with the above) can be helpful to avoid this!
10/n
So… when should we use DDAVP? Who actually benefits?
So let’s find out with tonight´s two fresh RCTs.
Buckle up — before biopsy bleeding shows up
#NephJC
So let’s find out with tonight´s two fresh RCTs.
Buckle up — before biopsy bleeding shows up
#NephJC
May 14, 2025 at 1:15 AM
So… when should we use DDAVP? Who actually benefits?
So let’s find out with tonight´s two fresh RCTs.
Buckle up — before biopsy bleeding shows up
#NephJC
So let’s find out with tonight´s two fresh RCTs.
Buckle up — before biopsy bleeding shows up
#NephJC
I really do love a nice 3% saline gtt and a DDAVP clamp. The closest you can get to “set it and forget it” with hyponatremia
March 30, 2024 at 1:32 PM
I really do love a nice 3% saline gtt and a DDAVP clamp. The closest you can get to “set it and forget it” with hyponatremia
🤔 No mortality. No nephrectomies.
Transfusions and embolizations rare.
So do we need DDAVP to prevent rare events?
Do soft endpoints justify prophylaxis? #NephJC
Transfusions and embolizations rare.
So do we need DDAVP to prevent rare events?
Do soft endpoints justify prophylaxis? #NephJC
May 14, 2025 at 1:48 AM
🤔 No mortality. No nephrectomies.
Transfusions and embolizations rare.
So do we need DDAVP to prevent rare events?
Do soft endpoints justify prophylaxis? #NephJC
Transfusions and embolizations rare.
So do we need DDAVP to prevent rare events?
Do soft endpoints justify prophylaxis? #NephJC
Yet another ddAVP trial for kidney biopsies with neutral results
academic.oup.com/ckj/advance-...
In Clinical Kidney Journal
Previous #NephJC discussion: www.nephjc.com/news/ddavp
academic.oup.com/ckj/advance-...
In Clinical Kidney Journal
Previous #NephJC discussion: www.nephjc.com/news/ddavp
Bleeding prevention with desmopressin for allograft kidney biopsies: a double-blind randomized study
AbstractBackground. Percutaneous kidney allograft biopsy is essential for evaluating graft dysfunction, but post-procedural bleeding remains the most frequ
academic.oup.com
March 14, 2026 at 12:05 PM
Yet another ddAVP trial for kidney biopsies with neutral results
academic.oup.com/ckj/advance-...
In Clinical Kidney Journal
Previous #NephJC discussion: www.nephjc.com/news/ddavp
academic.oup.com/ckj/advance-...
In Clinical Kidney Journal
Previous #NephJC discussion: www.nephjc.com/news/ddavp
💊 Different trials, different DDAVP strategies:
🔹Prasad et al: fixed 300 mcg intranasal dose
🔹Chakrabarti et al: weight-based 3 mcg/kg intranasal
🧬 Only Prasad tracked vWF & Factor VIII levels
#NephJC
🔹Prasad et al: fixed 300 mcg intranasal dose
🔹Chakrabarti et al: weight-based 3 mcg/kg intranasal
🧬 Only Prasad tracked vWF & Factor VIII levels
#NephJC
May 14, 2025 at 1:20 AM
💊 Different trials, different DDAVP strategies:
🔹Prasad et al: fixed 300 mcg intranasal dose
🔹Chakrabarti et al: weight-based 3 mcg/kg intranasal
🧬 Only Prasad tracked vWF & Factor VIII levels
#NephJC
🔹Prasad et al: fixed 300 mcg intranasal dose
🔹Chakrabarti et al: weight-based 3 mcg/kg intranasal
🧬 Only Prasad tracked vWF & Factor VIII levels
#NephJC
T0c
So how does DDAVP skip the bleeding drama? 🩸
🧬 Desmopressin → triggers cAMP → exocytosis of vWF & FVIII from endothelium
➡️ Boosts platelet adhesion in uremic dysfunction
⏱️ Onset: 30–90 min ⏳ Duration: 4–8 h
#NephJC
So how does DDAVP skip the bleeding drama? 🩸
🧬 Desmopressin → triggers cAMP → exocytosis of vWF & FVIII from endothelium
➡️ Boosts platelet adhesion in uremic dysfunction
⏱️ Onset: 30–90 min ⏳ Duration: 4–8 h
#NephJC
May 14, 2025 at 1:08 AM
T0c
So how does DDAVP skip the bleeding drama? 🩸
🧬 Desmopressin → triggers cAMP → exocytosis of vWF & FVIII from endothelium
➡️ Boosts platelet adhesion in uremic dysfunction
⏱️ Onset: 30–90 min ⏳ Duration: 4–8 h
#NephJC
So how does DDAVP skip the bleeding drama? 🩸
🧬 Desmopressin → triggers cAMP → exocytosis of vWF & FVIII from endothelium
➡️ Boosts platelet adhesion in uremic dysfunction
⏱️ Onset: 30–90 min ⏳ Duration: 4–8 h
#NephJC