Perioperative Vitamin C Fails to Prevent Complications After Kidney Biopsy in CKD Patients: Study

A recent study published in the journal of BMC Medicine evaluated the use of perioperative intravenous vitamin C in patients with chronic kidney disease (CKD) undergoing percutaneous renal biopsy (PRB), and found no significant benefit in reducing post-biopsy complications. They found that administration of vitamin C did not decrease the size of perirenal hematomas, alleviate post-biopsy pain, or reduce the incidence of bleeding complications within 24 hours of the procedure. These findings suggest that routine use of intravenous vitamin C is not supported as a strategy for preventing complications following kidney biopsy in CKD patients.

Percutaneous renal biopsy is a key diagnostic procedure for evaluating kidney diseases, particularly in patients with CKD. However, the procedure is commonly associated with complications such as perirenal hematoma and post-biopsy pain. Because vitamin C has shown promise in reducing perioperative bleeding and pain in some surgical settings, researchers investigated whether it could provide similar benefits during kidney biopsy.

This randomized controlled trial included 710 adults with CKD who were scheduled for ultrasound-guided native kidney biopsy. Participants were randomly assigned in a 1:1 ratio to receive either standard care or intravenous vitamin C at a dose of 20 mg/kg administered six hours before and 18 hours after the biopsy. The study assessed the size of perirenal hematoma detected by renal ultrasound 24 hours after the procedure and patient-reported pain intensity using the Visual Analogue Scale (VAS) at two, 12, and 24 hours after biopsy.

The adjusted mean difference in hematoma area between the vitamin C and control groups was 4.44 mm², which was not statistically significant. Similarly, after adjusting for multiple comparisons, no meaningful differences in pain scores between the two groups at any of the measured time points were observed. At 12 hours after the biopsy, patients who received vitamin C showed a less favorable distribution of pain severity when compared to those receiving standard care.

The incidence of any perirenal hematoma occurred in 56.3% of patients receiving vitamin C and 50.1% of those receiving standard care. Other bleeding complications and adverse events were uncommon and occurred at similar rates in both groups, indicating that vitamin C neither increased nor reduced procedural risk. Overall, perioperative intravenous vitamin C offers no measurable advantage in preventing bleeding, reducing hematoma size, or alleviating pain following percutaneous renal biopsy in patients with chronic kidney disease.

Source:

Li, J., Zhao, F., Lu, R., Zha, Y., Chang, F., Li, X., Gao, J., Shen, X., Jia, Q., Zhao, J., Che, X., Xu, X., Wu, M., Zhang, H., Zhang, Y., Chen, Y., Tan, X., & He, L. (2026). Effect of Vitamin C on bleeding and pain after kidney biopsy: a randomized controlled trial. BMC Medicine. https://doi.org/10.1186/s12916-026-05037-x