title: Lack of effectiveness of sodium bicarbonate in preventing kidney injury in patients undergoing cardiac surgery: a randomized controlled trial.
abstract: OBJECTIVE
  Because alkalinization of the renal tubules can theoretically protect against the mechanisms of acute kidney injury, we sought to determine whether a sodium bicarbonate infusion can prevent acute kidney injury after cardiac surgery.
  
  
  METHODS
  Prospective, randomized, double-blind, controlled trial.
  
  
  METHODS
  Cardiac surgery service in a community hospital.
  
  
  METHODS
  Ninety-two patients with stage 3 or higher chronic kidney disease who underwent cardiac surgery using cardiopulmonary bypass.
  
  
  METHODS
  Forty-eight patients received a perioperative intravenous infusion of 0.9% sodium chloride 154 mEq/L, and 44 patients received an infusion of sodium bicarbonate infusion 150 mEq/L in 5% dextrose solution; the infusions were started 1 hour preoperatively and continued for 6 hours after cardiopulmonary bypass.
  
  
  RESULTS
  The primary outcome was the development of any stage of acute kidney injury within 5 days after surgery as defined by the Acute Kidney Injury Network criteria. No statistically significant difference in the primary outcome was noted between the two groups: 32% in the bicarbonate group versus 42% in the sodium chloride group (p=0.12). Likewise, no significant differences in the 30-day hospital mortality rate or other adverse outcomes were noted between the two groups.
  
  
  CONCLUSIONS
  A perioperative infusion of sodium bicarbonate did not reduce the rate of acute kidney injury or adverse outcomes in patients with chronic kidney disease who underwent cardiac surgery.
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy, Wilkes University, Wilkes-Barre, Pennsylvania 18766, USA. Judith.kristeller@wilkes.edu
authors.forename: Judith L
authors.initials: JL
authors.lastname: Kristeller
authors.forename: Gerald S
authors.initials: GS
authors.lastname: Zavorsky
authors.forename: John E
authors.initials: JE
authors.lastname: Prior
authors.forename: Doris A
authors.initials: DA
authors.lastname: Keating
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Brady
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Romaldini
authors.forename: Tiera L
authors.initials: TL
authors.lastname: Hickman
authors.forename: Russell F
authors.initials: RF
authors.lastname: Stahl
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology / Q000517:prevention & control*; D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods; D002315:Cardiopulmonary Bypass / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D017052:Hospital Mortality; D006764:Hospitals, Community; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011446:Prospective Studies; D017693:Sodium Bicarbonate / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D017693:Sodium Bicarbonate
keywords: cardiopulmonary bypass; kidney injury; sodium bicarbonate