Perioperative Vitamin C fails to Reduce Bleeding Risk After Percutaneous Renal Biopsy: Study
China: Researchers have found that perioperative vitamin C supplementation did not significantly reduce bleeding complications in patients undergoing percutaneous renal biopsy. The findings suggest that routine use of vitamin C around the time of the procedure is unlikely to provide additional protection against biopsy-related bleeding, indicating that established bleeding prevention strategies should remain the standard of care.
The findings come from a randomized controlled trial published in BMC Medicine by Jipeng Li, Department of Nephrology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China, and colleagues.
Percutaneous renal biopsy (PRB) is a key diagnostic procedure for evaluating kidney diseases, particularly in patients with chronic kidney disease (CKD). Despite its clinical value, the procedure is commonly associated with complications such as perirenal hematoma and post-biopsy pain. Previous studies have suggested that vitamin C may reduce perioperative bleeding and pain in certain surgical settings, prompting researchers to investigate whether similar benefits could be achieved in patients undergoing kidney biopsy.
To evaluate its effectiveness, the investigators conducted a single-center, prospective, open-label, randomized controlled trial involving 710 adults with chronic kidney disease scheduled for ultrasound-guided native kidney biopsy. Participants were randomly assigned in a 1:1 ratio to receive either intravenous vitamin C (20 mg/kg administered 6 hours before and 18 hours after biopsy) or standard care alone.
The primary outcomes were the size of perirenal hematoma assessed by renal ultrasound 24 hours after biopsy and patient-reported pain intensity, measured using the Visual Analogue Scale (VAS) at 2, 12, and 24 hours following the procedure. The study also evaluated the incidence of bleeding complications and adverse events.
Key findings of the study include:
- Vitamin C did not significantly reduce the size of perirenal hematoma compared with standard care at 24 hours after biopsy.
- No significant differences were observed in post-biopsy pain scores between the vitamin C and control groups at 2, 12, or 24 hours.
- An exploratory analysis suggested a less favorable pain severity distribution at 12 hours in the vitamin C group.
- Perirenal hematoma occurred in 56.3% of patients receiving vitamin C and 50.1% of those receiving standard care, with no statistically significant difference between the groups.
- Rates of other bleeding complications and adverse events were low and comparable in both treatment groups.
The findings showed that perioperative intravenous vitamin C did not reduce bleeding complications, perirenal hematoma, or post-biopsy pain in patients with chronic kidney disease undergoing kidney biopsy.
The researchers concluded that the results do not support the routine use of perioperative intravenous vitamin C for patients undergoing percutaneous renal biopsy and emphasized that established bleeding prevention strategies should remain the standard approach.
Reference:
Li, J., Zhao, F., Lu, R. et al. Effect of Vitamin C on bleeding and pain after kidney biopsy: a randomized controlled trial. BMC Med (2026). https://doi.org/10.1186/s12916-026-05037-x
Next Story