Sodium bicarbonate versus normal saline for protection against contrast nephropathy

Autor:	Pooja Budhiraja, Zhao Chen, M. M. Popovtzer
Rok vydání:	2009
Předmět:	Male medicine.medical_specialty Cardiac Catheterization Bicarbonate medicine.medical_treatment Iohexol Contrast-induced nephropathy Urology Renal function Contrast Media Sodium Chloride Critical Care and Intensive Care Medicine Coronary Angiography chemistry.chemical_compound Electrolytes Renal Dialysis medicine Humans Saline Dialysis Aged Retrospective Studies Creatinine Sodium bicarbonate business.industry General Medicine Middle Aged medicine.disease Surgery Intravenous sodium bicarbonate Sodium Bicarbonate chemistry Nephrology Kidney Diseases business Glomerular Filtration Rate
Zdroj:	Renal failure. 31(2)
ISSN:	1525-6049
Popis:	Contrast-induced nephropathy (CIN) is a form of acute kidney injury and a significant source of morbidity and mortality. We defined CIN as an increase in serum creatinine (SCr) of 25% or more within 48 hours of receiving contrast. We retrospectively compared sodium bicarbonate with normal saline for prevention of CIN. One hundred and eighty-seven patients exposed to contrast during cardiac angiography, treated prophylactically either with sodium bicarbonate (n = 89) or with normal saline (n = 98), were studied. Baseline characteristics of both groups were similar in terms of age, amount of contrast, presence of diabetes mellitus, and use of furosemide and angiotensin-converting enzyme inhibitor. Patients in bicarbonate group had more severe renal disease with higher baseline SCr (1.58 +/- 0.5 mg/dL vs. 1.28 +/- 0.3 mg/dL, p = 0.001) and lower estimated glomerular filtration rate (eGFR, 51.06 +/- 14.0 mL/min vs. 62.3+/-13.5 mL/min, p = 0.001) compared to the normal saline group. After the contrast exposure, there was significant drop in eGFR (6.4%) and increase in SCr (11.3%) in the normal saline group and no significant change in the bicarbonate group. Three patients (3.4%) in the bicarbonate group as opposed to 14 patients (14.3%) in the normal saline group developed CIN (p = 0.011). Two patients in the normal saline group and none in the bicarbonate group needed dialysis. There was no significant difference in serum creatinine at three-month follow-up in either group. The above findings suggest that hydration with intravenous sodium bicarbonate is more effective than normal saline in preventing contrast-induced nephropathy.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::46b9024c24336c8ab870cb0f6b2dbc84 https://pubmed.ncbi.nlm.nih.gov/19212908 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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