title: Hydration with sodium bicarbonate does not prevent contrast nephropathy: a multicenter clinical trial.
abstract: BACKGROUND
  Radiographic contrast media exposition can cause acute renal function impairment. There is limited and conflicting evidence that hydration with sodium bicarbonate prevents contrast-induced nephropathy (CIN) in patients undergoing cardiac catheterization.
  
  
  OBJECTIVE
  The present study was aimed at determining whether sodium bicarbonate is superior to hydration with saline to prevent nephropathy in patients at risk undergoing cardiac catheterization.
  
  
  METHODS
  Three hundred and one patients undergoing coronary angiography or percutaneous coronary intervention with serum creatinine > 1.2mg/dL or glomerular filtration rate (GFR) < 50 ml/min were randomized to receive hydration with sodium bicarbonate starting 1 hour before the procedure and 6 hours after the procedure, or hydration with 0.9% saline. CIN was defined as an increase of 0.5mg/dL in creatinine in 48 h
  
  
  RESULTS
  Eighteen patients (5.9%) developed contrast induced nephropathy: 9 patients in the bicarbonate group (6.1%) and 9 patients in the saline group (6.0%), p = 0.97. The change in serum creatinine was similar in both groups, 0.01 ± 0.26 mg/dL in the bicarbonate group and 0.01 ± 0.35 mg/dL in the saline group, p = 0.9. No statistical difference was observed between the change in glomerular filtration rate (0.89 ± 9 ml/min vs. 2.29 ± 10 ml/min, p = 0.2 bicarbonate group and saline group, respectively).
  
  
  CONCLUSIONS
  Hydration with sodium bicarbonate was not superior to saline to prevent contrast media induced nephropathy in patients at risk undergoing cardiac catheterization.
authors.affiliation: Hospital São Lucas, PUCRS, Porto Alegre, RS, Brazil. vigomes@terra.com.br
authors.forename: Vitor O
authors.initials: VO
authors.lastname: Gomes
authors.forename: Ricardo
authors.initials: R
authors.lastname: Lasevitch
authors.forename: Valter C
authors.initials: VC
authors.lastname: Lima
authors.forename: Fábio S
authors.initials: FS
authors.lastname: Brito
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Perez-Alva
authors.forename: Bruno
authors.initials: B
authors.lastname: Moulin
authors.forename: Airton
authors.initials: A
authors.lastname: Arruda
authors.forename: Denise
authors.initials: D
authors.lastname: Oliveira
authors.forename: Paulo
authors.initials: P
authors.lastname: Caramori
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017693:Sodium Bicarbonate / Q000627:therapeutic use*; D012965:Sodium Chloride / Q000627:therapeutic use; D018709:Statistics, Nonparametric; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride; D017693:Sodium Bicarbonate; D003404:Creatinine