Document Detail


Sodium bicarbonate improves long-term clinical outcomes compared with sodium chloride in patients with chronic kidney disease undergoing an emergent coronary procedure.
MedLine Citation:
PMID:  18756037     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Masaharu Masuda; Takahisa Yamada; Yuji Okuyama; Takashi Morita; Shoji Sanada; Yoshio Furukawa; Yasumasa Tsukamoto; Keiji Okuda; Yuusuke Iwasaki; Taku Yasui; Masatake Fukunami
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2008-08-29
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  72     ISSN:  1346-9843     ISO Abbreviation:  Circ. J.     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-26     Completed Date:  2008-12-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1610-4     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Osaka General Medical Center, Osaka, Japan. furitumasuda@yahoo.co.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Contrast Media / adverse effects
Creatinine / blood
Emergencies
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic / chemically induced*,  drug therapy,  surgery
Male
Sodium Bicarbonate / therapeutic use*
Sodium Chloride / therapeutic use*
Survival Analysis
Survivors
Chemical
Reg. No./Substance:
0/Contrast Media; 144-55-8/Sodium Bicarbonate; 60-27-5/Creatinine; 7647-14-5/Sodium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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