title: Sodium bicarbonate therapy for the prevention of contrast-induced acute kidney injury – a systematic review and meta-analysis –.
abstract: BACKGROUND
  Sodium bicarbonate has been postulated to prevent contrast-induced acute kidney injury (CI-AKI) by various mechanisms, although the reports are conflicting.
  
  
  RESULTS
  We searched MEDLINE, EMBASE, and the Cochrane databases for randomized controlled trials that compared a sodium chloride with a sodium bicarbonate hydration regimen with regard to CI-AKI. Data across 19 clinical trials consisting of 3,609 patients were combined. Preprocedural hydration with sodium bicarbonate was associated with a significant decrease in the rate of CI-AKI (odds ratio [OR] 0.56; 95% confidence interval [CI] 0.36-0.86; P=0.008). Stratified analyses by the type of contrast medium suggested lower odds of CI-AKI with sodium bicarbonate in studies using low-osmolar contrast media (OR 0.40; 95% CI 0.23-0.71, P=0.002) compared with those using the iso-osmolar agents (OR 0.76; 95% CI 0.41-1.43; P=0.40). No significant difference in the rates of postprocedural death (OR 0.49; 95% CI 0.23-1.04; P=0.06) and the requirement for renal replacement therapy (OR 0.94; 95% CI 0.46-1.91; P=0.86) was observed. However, we found significant changes in serum bicarbonate and potassium levels after sodium bicarbonate infusion.
  
  
  CONCLUSIONS
  This updated meta-analysis demonstrates that sodium bicarbonate-based hydration is superior to sodium chloride in preventing CI-AKI of patients undergoing exposure to iodinated contrast media.
authors.affiliation: Busan Paik Hospital, University of Inje College of Medicine, Busan, Korea.
authors.forename: Jae-Sik
authors.initials: JS
authors.lastname: Jang
authors.forename: Han-Young
authors.initials: HY
authors.lastname: Jin
authors.forename: Jeong-Sook
authors.initials: JS
authors.lastname: Seo
authors.forename: Tae-Hyun
authors.initials: TH
authors.lastname: Yang
authors.forename: Dae-Kyeong
authors.initials: DK
authors.lastname: Kim
authors.forename: Tae Hee
authors.initials: TH
authors.lastname: Kim
authors.forename: Sang-Hwa
authors.initials: SH
authors.lastname: Urm
authors.forename: Dong-Soo
authors.initials: DS
authors.lastname: Kim
authors.forename: Dong-Kie
authors.initials: DK
authors.lastname: Kim
authors.forename: Sang-Hoon
authors.initials: SH
authors.lastname: Seol
authors.forename: Doo-Il
authors.initials: DI
authors.lastname: Kim
authors.forename: Kyoung-Im
authors.initials: KI
authors.lastname: Cho
authors.forename: Bo-Hyun
authors.initials: BH
authors.lastname: Kim
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Park
authors.forename: Hyung-Gon
authors.initials: HG
authors.lastname: Je
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Ahn
authors.forename: Won-Jang
authors.initials: WJ
authors.lastname: Kim
authors.forename: Jong-Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Seung-Whan
authors.initials: SW
authors.lastname: Lee
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000517:prevention & control*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016239:MEDLINE; D008297:Male; D017582:Renal Replacement Therapy; D017693:Sodium Bicarbonate / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000627:therapeutic use
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride; D017693:Sodium Bicarbonate