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10.2215/CJN.05370514

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suck abstract from ncbi


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pmid26185263
      Clin+J+Am+Soc+Nephrol 2015 ; 10 (9 ): 1519-24
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  • 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]
  • |Aged [MESH]
  • |Aged, 80 and over [MESH]
  • |Contrast Media/*adverse effects [MESH]
  • |Coronary Angiography [MESH]
  • |Double-Blind Method [MESH]
  • |Female [MESH]
  • |Glomerular Filtration Rate [MESH]
  • |Humans [MESH]
  • |Intention to Treat Analysis [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Prospective Studies [MESH]
  • |Renal Dialysis [MESH]
  • |Renal Insufficiency, Chronic/complications/physiopathology [MESH]
  • |Sodium Bicarbonate/*administration & dosage [MESH]


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