title: Sodium bicarbonate in preventing contrast nephropathy in patients at risk for volume overload: a randomized controlled trial.
abstract: BACKGROUND
  Sodium bicarbonate has been recently proposed as a prophylactic measure for the prevention of contrast-induced nephropathy (CIN). We aimed to compare the efficacy of the combination of sodium bicarbonate with half saline, and half saline alone in preventing CIN in patients having uncontrolled hypertension, compensated severe heart failure or a history of pulmonary edema.
  
  
  METHODS
  Seventy-two patients undergoing elective coronary angiography with a serum creatinine level > or =1.5 mg/dL who had uncontrolled hypertension, compensated severe heart failure or a history of pulmonary edema were prospectively enrolled in a single-center, double-blind, randomized, controlled trial from August 2007 to July 2008 and were assigned to either an infusion of sodium bicarbonate plus half saline (n=36) or half saline alone (n=36). The primary end point was an absolute (> or =0.5 mg/dL) or relative (> or =25%) increase in serum creatinine 48 hours after the procedure (CIN).
  
  
  RESULTS
  There were no significant differences between the groups regarding their baseline demographic and biochemical characteristics, as well as the underlying disease. A total of 6.1% of the patients receiving sodium bicarbonate plus half saline developed CIN as opposed to 6.3% of the patients in the half saline group, which was not statistically different (odds ratio = 0.97; 95% confidence interval, 0.13-7.3; p=1.0).
  
  
  CONCLUSIONS
  The combination therapy of sodium bicarbonate plus half saline does not offer additional benefits over hydration with half saline alone in the prevention of CIN.
authors.affiliation: Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran - Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Vasheghani-Farahani
authors.forename: Gelareh
authors.initials: G
authors.lastname: Sadigh
authors.forename: Seyed Ebrahim
authors.initials: SE
authors.lastname: Kassaian
authors.forename: Seyed Mohammad Reza
authors.initials: SM
authors.lastname: Khatami
authors.forename: Akbar
authors.initials: A
authors.lastname: Fotouhi
authors.forename: Seyed Amirhossein
authors.initials: SA
authors.lastname: Razavi
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Mansournia
authors.forename: Ali
authors.initials: A
authors.lastname: Kazemisaeid
authors.forename: Abbas
authors.initials: A
authors.lastname: Soleimani
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Pourhosseini
authors.forename: Mohammad
authors.initials: M
authors.lastname: Alidoosti
authors.forename: Ali Mohammad
authors.initials: AM
authors.lastname: Hajizeinali
authors.forename: Kianoush
authors.initials: K
authors.lastname: Hoseini
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Nematipour
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D001810:Blood Volume; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003404:Creatinine / Q000097:blood; D004311:Double-Blind Method; D005260:Female; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods*; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D007038:Hypotonic Solutions; D007262:Infusions, Intravenous; D007674:Kidney Diseases / Q000139:chemically induced / Q000503:physiopathology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011654:Pulmonary Edema / Q000150:complications; D017693:Sodium Bicarbonate / Q000008:administration & dosage*; D012965:Sodium Chloride / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D003287:Contrast Media; D007038:Hypotonic Solutions; D012965:Sodium Chloride; D017693:Sodium Bicarbonate; D003404:Creatinine