title: The Efficacy of Hydration with Normal Saline Versus Hydration with Sodium Bicarbonate in the Prevention of Contrast-induced Nephropathy.
abstract: BACKGROUND
  Contrast-induced acute kidney injury [contrast-induced nephropathy (CIN)] is one of the major causes of hospital-acquired acute renal failure. Volume supplementation is the most effective strategy to prevent acute renal failure caused by contrast; but the effects of sodium bicarbonate regimens are unknown in CIN prevention. The aim of this survey is to compare the efficacy of hydration with normal saline versus hydration with sodium bicarbonate in the prevention of the CIN in patients undergoing coronary angiography.
  
  
  METHODS
  In a clinical trial, 350 patients undergoing coronary interventions were randomized into two groups: One group received normal saline and another group received sodium bicarbonate before and after infusion of the contrast. Patients in both the groups had received N-acetylcysteine. CIN was defined as relative increase in serum creatinine equal to or more than 25% of baseline or increase to 0.5 mg/dl in 48 h after the injection of the contrast.
  
  
  RESULTS
  CIN was seen in 46 patients (13.1%) after coronary interventions. Incidence of CIN in patients receiving normal saline (19.4%) was more than in patients receiving sodium bicarbonate (6.9%) (P = 0.001). Hemodialysis was needed only in one patient who received saline normal. Relative risk to induce CIN in both groups was as 2.8 and was in the range of 1.50-5.25 with confidence interval of 95% and P = 0.001. Thus, the probability of CIN was significantly more in the usage of normal saline.
  
  
  CONCLUSIONS
  This survey showed that hydration with sodium bicarbonate is superior to hydration with normal saline and has better protection effects.
authors.affiliation: Department of Madani Heart Centre, Tabriz University of Medical Science, Tabriz, Iran.
authors.forename: Khalil
authors.initials: K
authors.lastname: Mahmoodi
authors.affiliation: Department of Madani Heart Centre, Tabriz University of Medical Science, Tabriz, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Sohrabi
authors.affiliation: Department of Madani Heart Centre, Tabriz University of Medical Science, Tabriz, Iran.
authors.forename: Farzad
authors.initials: F
authors.lastname: Ilkhchooyi
authors.affiliation: Department of Madani Heart Centre, Tabriz University of Medical Science, Tabriz, Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Malaki
authors.affiliation: Department of Madani Heart Centre, Tabriz University of Medical Science, Tabriz, Iran.
authors.forename: Mortaza E
authors.initials: ME
authors.lastname: Khaniani
authors.affiliation: Department of Madani Heart Centre, Tabriz University of Medical Science, Tabriz, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Hemmati
keywords: Contrast; nephropathy; sodium bicarbonate
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