Document Detail


A new protocol using sodium bicarbonate for the prevention of contrast-induced nephropathy in patients undergoing coronary angiography.
MedLine Citation:
PMID:  21420053     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Masayuki Motohiro; Hiroshi Kamihata; Satoshi Tsujimoto; Takeshi Seno; Kenichi Manabe; Tsuyoshi Isono; Yasuo Sutani; Fumio Yuasa; Toshiji Iwasaka
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2011-03-21
Journal Detail:
Title:  The American journal of cardiology     Volume:  107     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-05-17     Completed Date:  2011-08-17     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1604-8     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Cardiology, Kyoto Kujo Hospital, Kyoto, Japan. m3uk-motohiro@kujohp.or.jp
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MeSH Terms
Descriptor/Qualifier:
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:
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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