title: Sodium bicarbonate for the prevention of contrast-induced nephropathy: the efficacy of high concentration solution.
abstract: BACKGROUND
  The appropriate dose of sodium bicarbonate to prevent contrast-induced nephropathy (CIN) has not been established.
  
  
  RESULTS
  To determine the efficacy of high-concentration sodium bicarbonate, 123 consecutive patients with renal dysfunction undergoing coronary angiography with/without intervention were administrated either high-concentration (group H: 833 mEq/L, n = 87) or low-concentration (group L: 160 mEq/L, n = 36) sodium bicarbonate at the rate of 3 mL/kg/h for 1 hour before the contrast exposure, and followed by 1 mL/kg/h for 7 hours. A total of 77 patients (group H, n = 54; group L, n = 23) without prophylactic continuous hemodiafiltration were analyzed in this study. Urine pH (n = 10 for each group and n = 5 for control) was increased by concentration and time-dependent manner in each group. Urine pH at 3 hours after administration of sodium bicarbonate was significantly higher in group H than group L and control (8.50 ± 0.94 vs 6.95 ± 1.17 vs 5.70 ± 0.97, respectively; P<.001). Incidence of CIN (0% vs 17.3%; P=.005) was lower in group H than group L. Percent change in creatinine within 48 hours was significantly lower in group H than group L (-2.65 ± 9.83% vs 9.14 ± 14.0%; P=.001). Percent change in estimated glomerular filtration rate within 48 hours was significantly higher in group H than group L (3.97 ± 11.8 vs -7.43 ± 13.3; P<.001).
  
  
  CONCLUSIONS
  Administration of a higher concentration of sodium bicarbonate was more effective for urine alkalization and prevention of CIN.
authors.affiliation: Division of Cardiology, Nagoya City East Medical Center, Aichi, 464-8547 Japan. tamain04mfk@peace.ocn.ne.jp
authors.forename: Nozomu
authors.initials: N
authors.lastname: Tamai
authors.forename: Shigenori
authors.initials: S
authors.lastname: Ito
authors.forename: Kosuke
authors.initials: K
authors.lastname: Nakasuka
authors.forename: Kotaro
authors.initials: K
authors.lastname: Morimoto
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Miyata
authors.forename: Masahiko
authors.initials: M
authors.lastname: Inomata
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yoshida
authors.forename: Shin
authors.initials: S
authors.lastname: Suzuki
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Murakami
authors.forename: Koichi
authors.initials: K
authors.lastname: Sato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000009:adverse effects*; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000517:prevention & control*; D017693:Sodium Bicarbonate / Q000008:administration & dosage*; D012996:Solutions; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D012996:Solutions; D017693:Sodium Bicarbonate