Randomised trial of no hydration vs. sodium bicarbonate hydration in patients with chronic kidney disease undergoing acute computed tomography-pulmonary angiography
| Autor: | S. R. S. Ramai, C. J. Van Rooden, J. H. M. Groeneveld, Yvo W. J. Sijpkens, A. J. van der Molen, Judith Kooiman, Ton J. Rabelink, M. van Buren, Menno V. Huisman, Suzanne C. Cannegieter, Hein Putter, Nico J Aarts |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty pulmonary embolism medicine.medical_treatment Population Contrast Media Renal function prevention & control multidetector computed tomography chemistry.chemical_compound medicine Humans education Lung Dialysis Aged Creatinine education.field_of_study Sodium bicarbonate business.industry Angiography Acute kidney injury Water Hematology Middle Aged medicine.disease Surgery Pulmonary embolism Sodium Bicarbonate Treatment Outcome chemistry acute kidney injury Anesthesia randomized controlled trial Fluid Therapy Kidney Failure Chronic Female venous thrombosis Tomography X-Ray Computed business Kidney disease |
| Zdroj: | Journal of Thrombosis and Haemostasis, 12(10), 1658-1666 |
| Popis: | Summary Background Hydration to prevent contrast-induced acute kidney injury (CI-AKI) induces a diagnostic delay when performing computed tomography–pulmonary angiography (CTPA) in patients suspected of having acute pulmonary embolism. Aim To analyze whether withholding hydration is non-inferior to sodium bicarbonate hydration before CTPA in patients with chronic kidney disease (CKD). Methods We performed an open-label multicenter randomized trial between 2009 and 2013. One hundred thirty-nine CKD patients were randomized, of whom 138 were included in the intention-to-treat population: 67 were randomized to withholding hydration and 71 were randomized to 1-h 250 mL 1.4% sodium bicarbonate hydration before CTPA. Primary outcome was the increase in serum creatinine 48–96 h after CTPA. Secondary outcomes were the incidence of CI-AKI (creatinine increase > 25%/> 0.5 mg dL−1), recovery of renal function, and the need for dialysis within 2 months after CTPA. Withholding hydration was considered non-inferior if the mean relative creatinine increase was ≤ 15% compared with sodium bicarbonate. Results Mean relative creatinine increase was −0.14% (interquartile range −15.1% to 12.0%) for withholding hydration and −0.32% (interquartile range −9.7% to 10.1%) for sodium bicarbonate (mean difference 0.19%, 95% confidence interval −5.88% to 6.25%, P-value non-inferiority |
| Databáze: | OpenAIRE |
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