title: Sodium bicarbonate improves long-term clinical outcomes compared with sodium chloride in patients with chronic kidney disease undergoing an emergent coronary procedure.
abstract: BACKGROUND
  Contrast-induced nephropathy is associated with increased in-hospital and long-term adverse clinical outcomes.
  
  
  RESULTS
  To investigate whether hydration with sodium bicarbonate improves long-term clinical outcomes compared with sodium chloride, patients with chronic kidney disease undergoing an emergent coronary procedure were enrolled in a randomized clinical trial with > or = 1 year of follow-up. The 59 patients with chronic kidney disease (serum creatinine concentration > 1.1 mg/dl or estimated glomerular filtration rate < 60 ml/min) were randomly assigned to receive a 154 mmol/L intravenous infusion of either sodium bicarbonate (n = 30) or sodium chloride (n = 29). The electrolytes were given as a bolus of 3 ml.kg(-1).h(-1) for 1 h before the administration of contrast, followed by an infusion of 1 ml.kg(-1).h(-1) for 6 h during and after the procedure. During a mean follow-up period of 15.9+/-4.5 months, the incidence of renal replacement therapy or death was significantly lower in the sodium bicarbonate group than in the sodium chloride group (3% vs 21%, respectively; p = 0.037).
  
  
  CONCLUSIONS
  Hydration with sodium bicarbonate reduces the incidence of renal replacement therapy and death in patients with chronic kidney disease undergoing an emergent coronary procedure.
authors.affiliation: Division of Cardiology, Osaka General Medical Center, Osaka, Japan. furitumasuda@yahoo.co.jp
authors.forename: Masaharu
authors.initials: M
authors.lastname: Masuda
authors.forename: Takahisa
authors.initials: T
authors.lastname: Yamada
authors.forename: Yuji
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authors.lastname: Okuyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Morita
authors.forename: Shoji
authors.initials: S
authors.lastname: Sanada
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Furukawa
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Tsukamoto
authors.forename: Keiji
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authors.lastname: Okuda
authors.forename: Yuusuke
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authors.lastname: Iwasaki
authors.forename: Taku
authors.initials: T
authors.lastname: Yasui
authors.forename: Masatake
authors.initials: M
authors.lastname: Fukunami