Comparison of Usefulness of Sodium Bicarbonate Versus Sodium Chloride to Prevent Contrast-Induced Nephropathy in Patients Undergoing an Emergent Coronary Procedure
In the case of an emergency coronary procedure where the risk of contrast-induced nephropathy is especially high, there are few reliable methods to attenuate renal injury. We examined the efficacy of sodium bicarbonate for the prevention of contrast-induced nephropathy in patients undergoing an emer...
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| Veröffentlicht in: | The American journal of cardiology 2007-09, Vol.100 (5), p.781-786 |
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| creator | Masuda, Masaharu, MD Yamada, Takahisa, MD, PhD Mine, Takanao, MD, PhD Morita, Takashi, MD, PhD Tamaki, Shunsuke, MD Tsukamoto, Yasumasa, MD Okuda, Keiji, MD Iwasaki, Yuusuke, MD Hori, Masatsugo, MD, PhD Fukunami, Masatake, MD, PhD |
| description | In the case of an emergency coronary procedure where the risk of contrast-induced nephropathy is especially high, there are few reliable methods to attenuate renal injury. We examined the efficacy of sodium bicarbonate for the prevention of contrast-induced nephropathy in patients undergoing an emergency coronary procedure. We enrolled 59 patients who were scheduled to undergo an emergency coronary angiography or intervention. These patients were randomized to receive a 154-mEq/L infusion of sodium bicarbonate (n = 30) or sodium chloride (n = 29), as a bolus of 3 ml/kg/hour for 1 hour before the administration of contrast, followed by an infusion of 1 ml/kg/hour for 6 hours during and after the procedure. In the sodium bicarbonate group, serum creatinine concentration remained unchanged within 2 days of contrast administration (1.31 ± 0.52 to 1.31 ± 0.59 mg/dl), whereas it increased in the sodium chloride group (1.32 ± 0.65 to 1.52 ± 0.92 mg/dl, p = 0.01). The incidence of contrast-induced nephropathy (an increase >0.5 mg/dl or >25% in serum creatinine concentration within 2 days of contrast) was significantly lower in the sodium bicarbonate group than in the sodium chloride group (7% vs 35%, p = 0.01, risk ratio 0.19, 95% confidence interval 0.046 to 0.80). In conclusion, hydration with sodium bicarbonate is more effective than with sodium chloride for the prevention of contrast-induced nephropathy in patients undergoing an emergency coronary procedure. |
| doi_str_mv | 10.1016/j.amjcard.2007.03.098 |
| format | Article |
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We examined the efficacy of sodium bicarbonate for the prevention of contrast-induced nephropathy in patients undergoing an emergency coronary procedure. We enrolled 59 patients who were scheduled to undergo an emergency coronary angiography or intervention. These patients were randomized to receive a 154-mEq/L infusion of sodium bicarbonate (n = 30) or sodium chloride (n = 29), as a bolus of 3 ml/kg/hour for 1 hour before the administration of contrast, followed by an infusion of 1 ml/kg/hour for 6 hours during and after the procedure. In the sodium bicarbonate group, serum creatinine concentration remained unchanged within 2 days of contrast administration (1.31 ± 0.52 to 1.31 ± 0.59 mg/dl), whereas it increased in the sodium chloride group (1.32 ± 0.65 to 1.52 ± 0.92 mg/dl, p = 0.01). The incidence of contrast-induced nephropathy (an increase >0.5 mg/dl or >25% in serum creatinine concentration within 2 days of contrast) was significantly lower in the sodium bicarbonate group than in the sodium chloride group (7% vs 35%, p = 0.01, risk ratio 0.19, 95% confidence interval 0.046 to 0.80). In conclusion, hydration with sodium bicarbonate is more effective than with sodium chloride for the prevention of contrast-induced nephropathy in patients undergoing an emergency coronary procedure.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2007.03.098</identifier><identifier>PMID: 17719320</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angioplasty, Balloon, Coronary ; Biological and medical sciences ; Cardiology. Vascular system ; Cardiovascular ; Chemical compounds ; Clinical trials ; Comparative analysis ; Contrast Media - adverse effects ; Coronary Angiography ; Coronary heart disease ; Creatinine - blood ; Disease prevention ; Female ; Fluid Therapy ; Follow-Up Studies ; Glomerular Filtration Rate - drug effects ; Heart ; Humans ; Iopamidol - adverse effects ; Kidney diseases ; Kidney Diseases - chemically induced ; Kidney Diseases - prevention & control ; Male ; Medical imaging ; Medical sciences ; Risk Factors ; Sodium Bicarbonate - administration & dosage ; Sodium Bicarbonate - therapeutic use ; Sodium Chloride - administration & dosage ; Sodium Chloride - therapeutic use ; Stroke Volume - drug effects ; Time Factors</subject><ispartof>The American journal of cardiology, 2007-09, Vol.100 (5), p.781-786</ispartof><rights>Elsevier Inc.</rights><rights>2007 Elsevier Inc.</rights><rights>2007 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. 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We examined the efficacy of sodium bicarbonate for the prevention of contrast-induced nephropathy in patients undergoing an emergency coronary procedure. We enrolled 59 patients who were scheduled to undergo an emergency coronary angiography or intervention. These patients were randomized to receive a 154-mEq/L infusion of sodium bicarbonate (n = 30) or sodium chloride (n = 29), as a bolus of 3 ml/kg/hour for 1 hour before the administration of contrast, followed by an infusion of 1 ml/kg/hour for 6 hours during and after the procedure. In the sodium bicarbonate group, serum creatinine concentration remained unchanged within 2 days of contrast administration (1.31 ± 0.52 to 1.31 ± 0.59 mg/dl), whereas it increased in the sodium chloride group (1.32 ± 0.65 to 1.52 ± 0.92 mg/dl, p = 0.01). The incidence of contrast-induced nephropathy (an increase >0.5 mg/dl or >25% in serum creatinine concentration within 2 days of contrast) was significantly lower in the sodium bicarbonate group than in the sodium chloride group (7% vs 35%, p = 0.01, risk ratio 0.19, 95% confidence interval 0.046 to 0.80). In conclusion, hydration with sodium bicarbonate is more effective than with sodium chloride for the prevention of contrast-induced nephropathy in patients undergoing an emergency coronary procedure.</description><subject>Aged</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Biological and medical sciences</subject><subject>Cardiology. 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Vascular system</topic><topic>Cardiovascular</topic><topic>Chemical compounds</topic><topic>Clinical trials</topic><topic>Comparative analysis</topic><topic>Contrast Media - adverse effects</topic><topic>Coronary Angiography</topic><topic>Coronary heart disease</topic><topic>Creatinine - blood</topic><topic>Disease prevention</topic><topic>Female</topic><topic>Fluid Therapy</topic><topic>Follow-Up Studies</topic><topic>Glomerular Filtration Rate - drug effects</topic><topic>Heart</topic><topic>Humans</topic><topic>Iopamidol - adverse effects</topic><topic>Kidney diseases</topic><topic>Kidney Diseases - chemically induced</topic><topic>Kidney Diseases - prevention & control</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Risk Factors</topic><topic>Sodium Bicarbonate - administration & dosage</topic><topic>Sodium Bicarbonate - therapeutic use</topic><topic>Sodium Chloride - administration & dosage</topic><topic>Sodium Chloride - therapeutic use</topic><topic>Stroke Volume - drug effects</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Masuda, Masaharu, MD</creatorcontrib><creatorcontrib>Yamada, Takahisa, MD, PhD</creatorcontrib><creatorcontrib>Mine, Takanao, MD, PhD</creatorcontrib><creatorcontrib>Morita, Takashi, MD, PhD</creatorcontrib><creatorcontrib>Tamaki, Shunsuke, MD</creatorcontrib><creatorcontrib>Tsukamoto, Yasumasa, MD</creatorcontrib><creatorcontrib>Okuda, Keiji, MD</creatorcontrib><creatorcontrib>Iwasaki, Yuusuke, MD</creatorcontrib><creatorcontrib>Hori, Masatsugo, MD, PhD</creatorcontrib><creatorcontrib>Fukunami, Masatake, MD, PhD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Masuda, Masaharu, MD</au><au>Yamada, Takahisa, MD, PhD</au><au>Mine, Takanao, MD, PhD</au><au>Morita, Takashi, MD, PhD</au><au>Tamaki, Shunsuke, MD</au><au>Tsukamoto, Yasumasa, MD</au><au>Okuda, Keiji, MD</au><au>Iwasaki, Yuusuke, MD</au><au>Hori, Masatsugo, MD, PhD</au><au>Fukunami, Masatake, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of Usefulness of Sodium Bicarbonate Versus Sodium Chloride to Prevent Contrast-Induced Nephropathy in Patients Undergoing an Emergent Coronary Procedure</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2007-09-01</date><risdate>2007</risdate><volume>100</volume><issue>5</issue><spage>781</spage><epage>786</epage><pages>781-786</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>In the case of an emergency coronary procedure where the risk of contrast-induced nephropathy is especially high, there are few reliable methods to attenuate renal injury. We examined the efficacy of sodium bicarbonate for the prevention of contrast-induced nephropathy in patients undergoing an emergency coronary procedure. We enrolled 59 patients who were scheduled to undergo an emergency coronary angiography or intervention. These patients were randomized to receive a 154-mEq/L infusion of sodium bicarbonate (n = 30) or sodium chloride (n = 29), as a bolus of 3 ml/kg/hour for 1 hour before the administration of contrast, followed by an infusion of 1 ml/kg/hour for 6 hours during and after the procedure. In the sodium bicarbonate group, serum creatinine concentration remained unchanged within 2 days of contrast administration (1.31 ± 0.52 to 1.31 ± 0.59 mg/dl), whereas it increased in the sodium chloride group (1.32 ± 0.65 to 1.52 ± 0.92 mg/dl, p = 0.01). The incidence of contrast-induced nephropathy (an increase >0.5 mg/dl or >25% in serum creatinine concentration within 2 days of contrast) was significantly lower in the sodium bicarbonate group than in the sodium chloride group (7% vs 35%, p = 0.01, risk ratio 0.19, 95% confidence interval 0.046 to 0.80). In conclusion, hydration with sodium bicarbonate is more effective than with sodium chloride for the prevention of contrast-induced nephropathy in patients undergoing an emergency coronary procedure.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>17719320</pmid><doi>10.1016/j.amjcard.2007.03.098</doi><tpages>6</tpages></addata></record> |
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| subjects | Aged Angioplasty, Balloon, Coronary Biological and medical sciences Cardiology. Vascular system Cardiovascular Chemical compounds Clinical trials Comparative analysis Contrast Media - adverse effects Coronary Angiography Coronary heart disease Creatinine - blood Disease prevention Female Fluid Therapy Follow-Up Studies Glomerular Filtration Rate - drug effects Heart Humans Iopamidol - adverse effects Kidney diseases Kidney Diseases - chemically induced Kidney Diseases - prevention & control Male Medical imaging Medical sciences Risk Factors Sodium Bicarbonate - administration & dosage Sodium Bicarbonate - therapeutic use Sodium Chloride - administration & dosage Sodium Chloride - therapeutic use Stroke Volume - drug effects Time Factors |
| title | Comparison of Usefulness of Sodium Bicarbonate Versus Sodium Chloride to Prevent Contrast-Induced Nephropathy in Patients Undergoing an Emergent Coronary Procedure |
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