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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+J+Am+Soc+Nephrol
2015 ; 10
(9
): 1519-24
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English Wikipedia
Randomized Trial of Bicarbonate or Saline Study for the Prevention of
Contrast-Induced Nephropathy in Patients with CKD
#MMPMID26185263
Solomon R
; Gordon P
; Manoukian SV
; Abbott JD
; Kereiakes DJ
; Jeremias A
; Kim M
; Dauerman HL
Clin J Am Soc Nephrol
2015[Sep]; 10
(9
): 1519-24
PMID26185263
show ga
BACKGROUND AND OBJECTIVES: Sodium bicarbonate has been proposed for protection of
the kidney from contrast-induced AKI (CIAKI). However, the effects of bicarbonate
on long-term important clinical outcomes are uncertain. DESIGN, SETTING,
PARTICIPANTS, & MEASUREMENTS: In a prospective, double-blind, multicenter
randomized clinical trial, 391 patients with an eGFR<45 ml/min per 1.73 m(2)
undergoing elective coronary or peripheral angiography were randomized to an
infusion with a high dose of isotonic sodium bicarbonate (target 2.0 mEq/kg) or a
similar molar amount of isotonic sodium chloride. The primary outcome was a
composite of mortality, dialysis, or a sustained 20% reduction in eGFR at 6
months. RESULTS: There were 391 patients enrolled between March 2010 and May
2012. The incidence of the primary outcome was 14.9% in the bicarbonate group and
16.3% in the control group in the intention-to-treat population (P=0.78). There
was also no difference in the incidence of CIAKI between the treatment groups
(14.5% versus 12.1%, respectively; P=0.20). CIAKI was associated with a higher
incidence of sustained loss of kidney function at 6 months compared with those
without CIAKI (21.2% versus 7.7%, respectively; P=0.06). CONCLUSIONS: High-dose
sodium bicarbonate infusion in patients with eGFR<45 ml/min per 1.73 m(2)
undergoing angiography did not demonstrate a difference in incidence of the
composite of death, dialysis, or sustained 6-month reduction in eGFR or CIAKI
compared with sodium chloride.
|Acute Kidney Injury/chemically induced/mortality/physiopathology/*prevention &
control
[MESH]