BACKGROUND: Contrast-induced nephropathy is associated with increased in-hospital and long-term adverse clinical outcomes. METHODS AND RESULTS: To investigate whether hydration with sodium bicarbonate improves long-term clinical outcomes compared with sodium chloride, patients with chronic kidney disease undergoing an emergent coronary procedure were enrolled in a randomized clinical trial with > or = 1 year of follow-up. The 59 patients with chronic kidney disease (serum creatinine concentration > 1.1 mg/dl or estimated glomerular filtration rate < 60 ml/min) were randomly assigned to receive a 154 mmol/L intravenous infusion of either sodium bicarbonate (n = 30) or sodium chloride (n = 29). The electrolytes were given as a bolus of 3 ml.kg(-1).h(-1) for 1 h before the administration of contrast, followed by an infusion of 1 ml.kg(-1).h(-1) for 6 h during and after the procedure. During a mean follow-up period of 15.9+/-4.5 months, the incidence of renal replacement therapy or death was significantly lower in the sodium bicarbonate group than in the sodium chloride group (3% vs 21%, respectively; p = 0.037). CONCLUSIONS: Hydration with sodium bicarbonate reduces the incidence of renal replacement therapy and death in patients with chronic kidney disease undergoing an emergent coronary procedure.
RCT Entities:
BACKGROUND: Contrast-induced nephropathy is associated with increased in-hospital and long-term adverse clinical outcomes. METHODS AND RESULTS: To investigate whether hydration with sodium bicarbonate improves long-term clinical outcomes compared with sodium chloride, patients with chronic kidney disease undergoing an emergent coronary procedure were enrolled in a randomized clinical trial with > or = 1 year of follow-up. The 59 patients with chronic kidney disease (serum creatinine concentration > 1.1 mg/dl or estimated glomerular filtration rate < 60 ml/min) were randomly assigned to receive a 154 mmol/L intravenous infusion of either sodium bicarbonate (n = 30) or sodium chloride (n = 29). The electrolytes were given as a bolus of 3 ml.kg(-1).h(-1) for 1 h before the administration of contrast, followed by an infusion of 1 ml.kg(-1).h(-1) for 6 h during and after the procedure. During a mean follow-up period of 15.9+/-4.5 months, the incidence of renal replacement therapy or death was significantly lower in the sodium bicarbonate group than in the sodium chloride group (3% vs 21%, respectively; p = 0.037). CONCLUSIONS: Hydration with sodium bicarbonate reduces the incidence of renal replacement therapy and death in patients with chronic kidney disease undergoing an emergent coronary procedure.
Authors: Jeremiah R Brown; Daniel M Pearlman; Emily J Marshall; Shama S Alam; Todd A MacKenzie; Alejandro Recio-Mayoral; Vitor O Gomes; Bokyung Kim; Lisette O Jensen; Christian Mueller; Mauro Maioli; Richard J Solomon Journal: Am J Cardiol Date: 2016-08-24 Impact factor: 2.778
Authors: Mehmet Kanbay; Adrian Covic; Steven G Coca; Faruk Turgut; Ali Akcay; Chirag R Parikh Journal: Int Urol Nephrol Date: 2009-04-25 Impact factor: 2.370