Haemostasis and beyond: The expanding role of desmopressin in intensive care

Table 2 Desmopressin use in renal and hepatic dysfunction

Clinical setting	eGFR	Recommended dose	Dosing interval	Key considerations
Mild-Moderate renal impairment	eGFR 30-60 mL/min	0.15-0.2 µg/kg IV or SC	Every 24-48 hours	Monitor serum sodium every 6-12 hours; avoid free water intake
Severe renal impairment	eGFR < 30 mL/min	Avoid for antidiuresis	—	High risk of hyponatremia and water intoxication
End stage renal disease/hemodialysis (for bleeding only)	On dialysis	0.3 µg/kg IV over 20-30 minutes	Single dose only; no repeat within 48-72 hours	Administer post-dialysis; enforce strict fluid restriction (≤ 1 L/day); monitor sodium every 6-8 hours
Hepatic dysfunction (e.g., Cirrhosis)	All stages	0.3 µg/kg IV over 20-30 minutes	Single dose only	Use for variceal bleeding or pre-procedure; monitor for thrombosis; avoid repeat dosing

eGFR: Estimated glomerular filtration rate; IV: Intravenous; SC: Subcutaneous.