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Sodium bicarbonate for the prevention of contrast-induced nephropathy: the efficacy of high concentration solution.
MedLine Citation:
PMID:  22954563     Owner:  NLM     Status:  In-Data-Review    
BACKGROUND: The appropriate dose of sodium bicarbonate to prevent contrast-induced nephropathy (CIN) has not been established.
METHODS AND RESULTS: To determine the efficacy of high-concentration sodium bicarbonate, 123 consecutive patients with renal dysfunction undergoing coronary angiography with/without intervention were administrated either high-concentration (group H: 833 mEq/L, n = 87) or low-concentration (group L: 160 mEq/L, n = 36) sodium bicarbonate at the rate of 3 mL/kg/h for 1 hour before the contrast exposure, and followed by 1 mL/kg/h for 7 hours. A total of 77 patients (group H, n = 54; group L, n = 23) without prophylactic continuous hemodiafiltration were analyzed in this study. Urine pH (n = 10 for each group and n = 5 for control) was increased by concentration and time-dependent manner in each group. Urine pH at 3 hours after administration of sodium bicarbonate was significantly higher in group H than group L and control (8.50 ± 0.94 vs 6.95 ± 1.17 vs 5.70 ± 0.97, respectively; P<.001). Incidence of CIN (0% vs 17.3%; P=.005) was lower in group H than group L. Percent change in creatinine within 48 hours was significantly lower in group H than group L (-2.65 ± 9.83% vs 9.14 ± 14.0%; P=.001). Percent change in estimated glomerular filtration rate within 48 hours was significantly higher in group H than group L (3.97 ± 11.8 vs -7.43 ± 13.3; P<.001).
CONCLUSION: Administration of a higher concentration of sodium bicarbonate was more effective for urine alkalization and prevention of CIN.
Nozomu Tamai; Shigenori Ito; Kosuke Nakasuka; Kotaro Morimoto; Kazuyuki Miyata; Masahiko Inomata; Takayuki Yoshida; Shin Suzuki; Yoshimasa Murakami; Koichi Sato
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  24     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-09-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  439-42     Citation Subset:  IM    
Division of Cardiology, Nagoya City East Medical Center: 1-2-23 Wakamizu, Chikusa-ku, Nagoya, Aichi, 464-8547 Japan.
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