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Sodium Bicarbonate Prevents Contrast-Induced Nephropathy in Addition to
Theophylline: A Randomized Controlled Trial
#MMPMID27227933
Huber W
; Huber T
; Baum S
; Franzen M
; Schmidt C
; Stadlbauer T
; Beitz A
; Schmid RM
; Schmid S
Medicine (Baltimore)
2016[May]; 95
(21
): e3720
PMID27227933
show ga
In this study, we investigated whether hydration with sodium bicarbonate is
superior to hydration with saline in addition to theophylline (both groups) in
the prophylaxis of contrast-induced nephropathy (CIN). It was a prospective,
randomized, double-blinded study in a university hospital on 2 general intensive
care units (63% of investigations) and normal wards.After approval of the local
ethics committee and informed consent 152 patients with screening serum
creatinine ?1.1?mg/dL and/or at least 1 additional risk factor for CIN undergoing
intravascular contrast media (CM) exposure were randomized to receive a total of
9?mL/kg bicarbonate 154?mmol/L (group B; n?=?74) or saline 0.9% (group S; n?=?78)
hydration within 7?h in addition to intravenous application of 200?mg
theophylline. Serum creatinine was determined immediately before, 24 and 48?h
after CM exposure. As primary endpoint we investigated the incidence of CIN
(increase of serum creatinine ?0.5?mg/dL and/or ?25% within 48?h of CM).Both
groups were comparable regarding baseline characteristics. Incidence of CIN was
significantly less frequent with bicarbonate compared to sodium hydration (1/74
[1.4%] vs 7/78 [9.0%]; P?=?0.035). Time course of serum creatinine was more
favorable in group B with decreases in serum creatinine after 24?h (-0.084?mg/dL
[95% confidence interval: -0.035 to -0.133?mg/dL]; P?=?0.008) and 48?h
(-0.093?mg/dL (-0.025 to -0.161?mg/dL); P?=?0.007) compared to baseline which
were not observed in group S.In patients at increased risk of CIN receiving
prophylactic theophylline, hydration with sodium bicarbonate reduces
contrast-induced renal impairment compared to hydration with saline.
|Aged
[MESH]
|Aged, 80 and over
[MESH]
|Contrast Media/*adverse effects
[MESH]
|Creatinine/blood
[MESH]
|Double-Blind Method
[MESH]
|Drug Therapy, Combination
[MESH]
|Female
[MESH]
|Hospitals, University
[MESH]
|Humans
[MESH]
|Male
[MESH]
|Middle Aged
[MESH]
|Prospective Studies
[MESH]
|Renal Insufficiency/*chemically induced/*prevention & control
[MESH]
|Risk Factors
[MESH]
|Sodium Bicarbonate/administration & dosage/*therapeutic use
[MESH]
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