{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:59:23Z","timestamp":1790301563497,"version":"4.1.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T00:00:00Z","timestamp":1790294400000},"content-version":"vor","delay-in-days":84,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"from Xijing Hospital, the First Affiliated Hospital of the Air Force Medical University","award":["XJZT24CY43"],"award-info":[{"award-number":["XJZT24CY43"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Percutaneous renal biopsy (PRB) is an essential diagnostic procedure for kidney diseases, yet postbiopsy perirenal hematoma and pain remain frequent complications. Vitamin C has emerging evidence supporting its role in reducing perioperative bleeding and pain, but its efficacy in the context of PRB is unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center, prospective, open-label, randomized controlled trial enrolled 710 adults with chronic kidney disease (CKD) scheduled for an ultrasound-guided native kidney biopsy. Participants were randomly assigned (1:1) to receive perioperative intravenous vitamin C (20\u2009mg\/kg at 6\u2009h before and 18\u2009h after biopsy) or standard care alone. The primary outcomes were the area of perirenal hematoma on renal ultrasound at 24\u2009h and self-reported pain intensity (Visual Analogue Scale, VAS) at 2, 12, and 24\u2009h post-biopsy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All 710 randomized participants were included in the analysis. The adjusted mean difference in hematoma area at 24\u2009h was 4.44\u2009mm\u00b2 (95% CI, \u221252.31 to 61.18; P\u2009=\u20090.878). After multiple testing correction, there were no significant differences in the primary pain outcome (VAS scores) between groups at any time point; however, an exploratory analysis of pain severity categories indicated a less favorable distribution in the Vitamin C group at 12\u2009h (P for trend =0.033). The incidence of any perirenal hematoma was 56.3% in the vitamin C group versus 50.1% in the control group (risk ratio, 1.12; 95% CI, 0.98\u20131.29; P\u2009=\u20090.098). Rates of other bleeding complications and adverse events were low and comparable between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In CKD patients undergoing PRB, perioperative intravenous vitamin C did not reduce the size of perirenal hematoma, alleviate postbiopsy pain, or decrease the incidence of bleeding complications within 24\u2009h. These findings do not support the routine use of vitamin C for preventing complications after kidney biopsy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12916-026-05037-x","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:26:08Z","timestamp":1783085168000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Vitamin C on bleeding and pain after kidney biopsy: a randomized controlled trial"],"prefix":"10.1186","volume":"24","author":[{"given":"Jipeng","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Zha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengpei","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiayin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingli","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Jia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaolan","family":"Che","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaomeng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengting","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuting","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinrui","family":"Tan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijie","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"5037_CR1","doi-asserted-by":"publisher","first-page":"1595","DOI":"10.2215\/CJN.04710420","volume":"15","author":"ED Poggio","year":"2020","unstructured":"Poggio ED, McClelland RL, Blank KN, Hansen S, Bansal S, Bomback AS, et al. Systematic review and meta-analysis of native kidney biopsy complications. Clin J Am Soc Nephrol. 2020;15:1595\u2013602.","journal-title":"Clin J Am Soc Nephrol"},{"key":"5037_CR2","doi-asserted-by":"publisher","first-page":"1591","DOI":"10.2215\/CJN.02150212","volume":"7","author":"C Tondel","year":"2012","unstructured":"Tondel C, Vikse BE, Bostad L, Svarstad E. Safety and complications of percutaneous kidney biopsies in 715 children and 8573 adults in Norway 1988-2010. Clin J Am Soc Nephrol. 2012;7:1591\u20137.","journal-title":"Clin J Am Soc Nephrol"},{"key":"5037_CR3","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1093\/ckj\/sfx012","volume":"10","author":"JS Lees","year":"2017","unstructured":"Lees JS, McQuarrie EP, Mordi N, Geddes CC, Fox JG, Mackinnon B. Risk factors for bleeding complications after nephrologist-performed native renal biopsy. Clin Kidney J. 2017;10:573\u20137.","journal-title":"Clin Kidney J"},{"key":"5037_CR4","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1016\/j.amjms.2016.12.019","volume":"353","author":"DM Xu","year":"2017","unstructured":"Xu DM, Chen M, Zhou FD, Zhao MH. Risk factors for severe bleeding complications in percutaneous renal biopsy. Am J Med Sci. 2017;353:230\u20135.","journal-title":"Am J Med Sci"},{"key":"5037_CR5","doi-asserted-by":"publisher","first-page":"850","DOI":"10.1053\/j.ajkd.2010.12.019","volume":"57","author":"C Manno","year":"2011","unstructured":"Manno C, Bonifati C, Torres DD, Campobasso N, Schena FP. Desmopressin acetate in percutaneous ultrasound-guided kidney biopsy: a randomized controlled trial. Am J Kidney Dis. 2011;57:850\u20135.","journal-title":"Am J Kidney Dis"},{"key":"5037_CR6","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/s13741-023-00358-4","volume":"13","author":"C Wang","year":"2024","unstructured":"Wang C, Lebedeva V, Yang J, Anih J, Park LJ, Paczkowski F, et al. Desmopressin to reduce periprocedural bleeding and transfusion: a systematic review and meta-analysis. Perioper Med (Lond). 2024;13:5.","journal-title":"Perioper Med (Lond)"},{"key":"5037_CR7","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1111\/ejh.13930","volume":"110","author":"A Mohinani","year":"2023","unstructured":"Mohinani A, Patel S, Tan V, Kartika T, Olson S, DeLoughery TG, et al. Desmopressin as a hemostatic and blood sparing agent in bleeding disorders. Eur J Haematol. 2023;110:470\u20139.","journal-title":"Eur J Haematol"},{"key":"5037_CR8","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1007\/s11255-019-02155-9","volume":"51","author":"CC Lim","year":"2019","unstructured":"Lim CC, Siow B, Choo JCJ, Chawla M, Chin YM, Kee T, et al. Desmopressin for the prevention of bleeding in percutaneous kidney biopsy: efficacy and hyponatremia. Int Urol Nephrol. 2019;51:995\u20131004.","journal-title":"Int Urol Nephrol"},{"key":"5037_CR9","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1159\/000526325","volume":"147","author":"J Izawa","year":"2023","unstructured":"Izawa J, Matsuzaki K, Raita Y, Uehara G, Nishioka N, Yano H, et al. Intravenous tranexamic acid in percutaneous kidney biopsy: a randomized controlled trial. Nephron. 2023;147:144\u201351.","journal-title":"Nephron"},{"key":"5037_CR10","doi-asserted-by":"publisher","first-page":"2068","DOI":"10.1089\/ars.2013.5205","volume":"19","author":"JM May","year":"2013","unstructured":"May JM, Harrison FE. Role of vitamin C in the function of the vascular endothelium. Antioxid Redox Signal. 2013;19:2068\u201383.","journal-title":"Antioxid Redox Signal"},{"key":"5037_CR11","doi-asserted-by":"publisher","first-page":"1856","DOI":"10.1177\/0300060518817408","volume":"47","author":"JH Kwon","year":"2019","unstructured":"Kwon JH, Kim D, Cho H, Shin BS. Ascorbic acid improves thrombotic function of platelets during living donor liver transplantation by modulating the function of the E3 ubiquitin ligases c-Cbl and Cbl-b. J Int Med Res. 2019;47:1856\u201367.","journal-title":"J Int Med Res"},{"issue":"10","key":"5037_CR12","doi-asserted-by":"publisher","first-page":"1993","DOI":"10.3390\/antiox11101993","volume":"11","author":"A G\u0119gotek","year":"2022","unstructured":"G\u0119gotek A, Skrzydlewska E. Antioxidative and anti-inflammatory activity of ascorbic acid. Antioxidants. 2022;11(10):1993.","journal-title":"Antioxidants"},{"key":"5037_CR13","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.clnesp.2022.03.024","volume":"49","author":"S Farahani-Jam","year":"2022","unstructured":"Farahani-Jam S, Yaghmaei M, Vahdat Shariatpanahi Z. Effect of intravenous ascorbic acid administration on hemorrhage and wound complications in total abdominal hysterectomy: A prospective randomized clinical trial. Clin Nutr ESPEN. 2022;49:74\u201378.","journal-title":"Clin Nutr ESPEN"},{"key":"5037_CR14","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1111\/ases.12977","volume":"15","author":"Z Vahdat Shariatpanahi","year":"2022","unstructured":"Vahdat Shariatpanahi Z, Shahbazi S, Shahbazi E. Ascorbic acid to prevent postpolypectomy bleeding in the colon: a randomized controlled trial. Asian J Endosc Surg. 2022;15:103\u20139.","journal-title":"Asian J Endosc Surg"},{"issue":"10","key":"5037_CR15","doi-asserted-by":"publisher","first-page":"3109","DOI":"10.3390\/nu12103109","volume":"12","author":"KC Hung","year":"2020","unstructured":"Hung KC, Lin YT, Chen KH, Wang LK, Chen JY, Chang YJ, et al. The effect of perioperative vitamin C on postoperative analgesic consumption: a meta-analysis of randomized controlled trials. Nutrients. 2020;12(10):3109.","journal-title":"Nutrients"},{"issue":"7","key":"5037_CR16","first-page":"UC07","volume":"18","author":"ND Rachana","year":"2024","unstructured":"Rachana ND, Ranganath N, Pallavi VR, Shashidhar GS, Arathi BH, Gowda VB. Effect of intravenous vitamin C and N acetylcysteine on postoperative pain and opioid consumption after laparoscopic gynaecologic oncosurgeries: a randomised controlled study. J Clin Diagn Res. 2024;18(7):UC07\u2013UC11.","journal-title":"J Clin Diagn Res"},{"key":"5037_CR17","doi-asserted-by":"publisher","first-page":"533","DOI":"10.7326\/0003-4819-140-7-200404060-00010","volume":"140","author":"SJ Padayatty","year":"2004","unstructured":"Padayatty SJ, Sun H, Wang Y, Riordan HD, Hewitt SM, Katz A, et al. Vitamin C pharmacokinetics: implications for oral and intravenous use. Ann Intern Med. 2004;140:533\u20137.","journal-title":"Ann Intern Med"},{"key":"5037_CR18","first-page":"1023","volume":"18","author":"Institutions MUBoSAfN-gM","year":"2021","unstructured":"Institutions MUBoSAfN-gM. Practice guidelines for percutaneous ultrsound-guided renal biopsy. Chin J Med Ultrasound (Electronic Edition). 2021;18:1023\u201343.","journal-title":"Chin J Med Ultrasound (Electronic Edition)"},{"key":"5037_CR19","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.pharmthera.2008.05.002","volume":"119","author":"R Aguirre","year":"2008","unstructured":"Aguirre R, May JM. Inflammation in the vascular bed: importance of vitamin C. Pharmacol Ther. 2008;119:96\u2013103.","journal-title":"Pharmacol Ther"},{"key":"5037_CR20","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1016\/S0899-3467(07)60070-6","volume":"2","author":"N Calvino","year":"2003","unstructured":"Calvino N. Connective tissue: Vascular and hematological (blood) support. J Chiropr Med. 2003;2:25\u201336.","journal-title":"J Chiropr Med"},{"key":"5037_CR21","doi-asserted-by":"publisher","first-page":"102753","DOI":"10.1016\/j.redox.2023.102753","volume":"63","author":"T Kietzmann","year":"2023","unstructured":"Kietzmann T. Vitamin C: From nutrition to oxygen sensing and epigenetics. Redox Biol. 2023;63:102753.","journal-title":"Redox Biol"},{"key":"5037_CR22","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1055\/s-0034-1396961","volume":"32","author":"SA Kennedy","year":"2015","unstructured":"Kennedy SA, Milovanovic L, Midia M. Major bleeding after percutaneous image-guided biopsies: frequency, predictors, and periprocedural management. Semin Intervent Radiol. 2015;32:26\u201333.","journal-title":"Semin Intervent Radiol"},{"issue":"14","key":"5037_CR23","doi-asserted-by":"publisher","first-page":"2472","DOI":"10.3390\/ijerph16142472","volume":"16","author":"A Tada","year":"2019","unstructured":"Tada A, Miura H. The relationship between vitamin C and periodontal diseases: a systematic review. Int J Environ Res Public Health. 2019;16(14):2472.","journal-title":"Int J Environ Res Public Health"},{"issue":"2","key":"5037_CR24","doi-asserted-by":"publisher","first-page":"ujaf050","DOI":"10.1093\/biomtc\/ujaf050","volume":"81","author":"Z Wang","year":"2025","unstructured":"Wang Z, Ling W, Wang T. A semiparametric quantile regression rank score test for zero-inflated data. Biometrics. 2025;81(2):ujaf050.","journal-title":"Biometrics"},{"key":"5037_CR25","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1016\/j.neubiorev.2017.01.039","volume":"75","author":"S Lautenbacher","year":"2017","unstructured":"Lautenbacher S, Peters JH, Heesen M, Scheel J, Kunz M. Age changes in pain perception: A systematic-review and meta-analysis of age effects on pain and tolerance thresholds. Neurosci Biobehav Rev. 2017;75:104\u201313.","journal-title":"Neurosci Biobehav Rev"},{"key":"5037_CR26","doi-asserted-by":"publisher","first-page":"9147279","DOI":"10.1155\/2016\/9147279","volume":"2016","author":"Y Jeon","year":"2016","unstructured":"Jeon Y, Park JS, Moon S, Yeo J. Effect of intravenous high dose vitamin C on postoperative pain and morphine use after laparoscopic colectomy: a randomized controlled trial. Pain Res Manag. 2016;2016:9147279.","journal-title":"Pain Res Manag"}],"container-title":["BMC Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12916-026-05037-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-026-05037-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12916-026-05037-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:17:01Z","timestamp":1790299021000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12916-026-05037-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5037"],"URL":"https:\/\/doi.org\/10.1186\/s12916-026-05037-x","relation":{},"ISSN":["1741-7015"],"issn-type":[{"value":"1741-7015","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]},"assertion":[{"value":"22 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 July 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Ethics approval was obtained from the institutional ethics committee. Informed consent was obtained from all individual participants included in the study. The trial has been registered with the Chinese Clinical Trial Registry (ChiCTR2500106962).","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"515"}}