 Percutaneous liver biopsy PLB is the gold standard for grading necroinflammation and staging fibrosis in patients with chronic viral hepatitis. Whether the use of 1-deamino-8-D-arginine vasopressin DDAVP before PLBs in hemodialysis HD patients with chronic viral hepatitis has comparable safety profiles to those with normal renal function NRF has not been evaluated in prospective studies. 