| A new protocol using sodium bicarbonate for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography. | |
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MedLine Citation:
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PMID: 21420053 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Contrast-induced nephropathy (CIN) is associated with increased morbidity and mortality rates. Although a previous study reported that pretreatment with sodium bicarbonate is more effective than sodium chloride for prophylaxis of CIN, this has not been a universal finding. We performed a prospective randomized trial to investigate whether CIN can be avoided using sodium bicarbonate. In total 155 patients with a glomerular filtration rate (GFR) <60 ml/min/1.73 m(2) who were undergoing coronary angiography were enrolled. We assigned patients to sodium chloride plus sodium bicarbonate (bicarbonate group, n = 78) or sodium chloride alone (chloride group, n = 77). Infusion of sodium bicarbonate at 1 ml/kg/hour continued from 3 hours before to 6 hours after coronary angiography. CIN was defined as a 25% increase in serum creatinine from baseline value or an absolute increase of ≥0.5 mg/dl, which appeared within 2 days of contrast. Baseline GFR was not significantly different between the 2 groups. Patients in the bicarbonate group had a higher GFR than those in the chloride group on day 2 (45.8 ± 13.4 vs 40.9 ± 14.6 ml/min/1.73 m(2), p = 0.031) and at 1 month (49.5 ± 14.7 vs 43.7 ± 15.5 ml/min/1.73 m(2), p = 0.019). CIN occurred in 10 patients (13%) in the chloride group but in only 2 patients (2.6%) in the bicarbonate group (p = 0.012). Sodium chloride plus sodium bicarbonate is more effective than sodium chloride alone for prophylaxis of CIN and can lead to retention of better long-term renal function. |
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Authors:
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Masayuki Motohiro; Hiroshi Kamihata; Satoshi Tsujimoto; Takeshi Seno; Kenichi Manabe; Tsuyoshi Isono; Yasuo Sutani; Fumio Yuasa; Toshiji Iwasaka |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial Date: 2011-03-21 |
Journal Detail:
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Title: The American journal of cardiology Volume: 107 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-05-17 Completed Date: 2011-08-17 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1604-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, Kyoto Kujo Hospital, Kyoto, Japan. m3uk-motohiro@kujohp.or.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Contrast Media / adverse effects* Coronary Angiography* Female Humans Kidney Diseases / chemically induced*, prevention & control* Male Middle Aged Sodium Bicarbonate / pharmacology* Sodium Chloride / pharmacology |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 144-55-8/Sodium Bicarbonate; 7647-14-5/Sodium Chloride |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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