title: Meta-Analysis of Sodium Bicarbonate Therapy for Prevention of Cardiac Surgery-Associated Acute Kidney Injury.
abstract: OBJECTIVE
  The aim of this study was to determine whether or not perioperative administration of sodium bicarbonate had a preventive effect on cardiac surgery-associated acute kidney injury (CSA-AKI) as shown in randomized controlled trials.
  
  
  METHODS
  The authors conducted a systematic review and meta-analysis using MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and KoreaMed.
  
  
  METHODS
  The authors searched MEDLINE, EMBASE, CENTRAL, and KoreaMed without language and date restrictions. They used both MeSH and free-text terms to identify relevant studies. Electronic searches were undertaken on July 31, 2014.
  
  
  METHODS
  Five randomized controlled studies included in this review.
  
  
  RESULTS
  There were no differences in the development of CSA-AKI among patients in the sodium bicarbonate group compared with those in the control group (5 trials, 1,092 patients; n = 233 of 547 in sodium bicarbonate (SB) group versus 225 of 545 in control group (SC); risk ratio (RR), 0.95; 95% confidence interval (CI), 0.74-1.22. Also, there were no statistical differences in in-hospital mortality (3 trials, 573 patients; n = 21 of 288 in SB versus 14 of 285 in SC; RR, 1.44; 95% CI, 0.76-2.72), need for renal replacement therapy (4 trials, 1,000 patients; n = 21 of 503 in SB versus 23 of 497 in SC; RR, 0.90; 95% CI, 0.50-1.60), length of stay in the intensive care unit (ICU) (hours) (4 trials, n = 969 patients, weighted men difference (WMD), 2.17; 95% CI, -1.15-5.49), and length of ventilation (hours) (4 trials, 969 patients; WMD, 0.34; 95% CI,-0.80-1.48).
  
  
  CONCLUSIONS
  Perioperative administration of sodium bicarbonate did not reduce the rate of CSA-AKI in randomized controlled trials. Therefore, use of perioperative administration of sodium bicarbonate for the prevention of CSA-AKI is questionable.
authors.affiliation: Departments of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University, Goyang, Korea.
authors.forename: Jun Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Departments of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University, Goyang, Korea. Electronic address: jy925@paik.ac.kr.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
authors.forename: Hyeong sik
authors.initials: Hs
authors.lastname: Ahn
authors.affiliation: Preventive Medicine, College of Medicine, Korea University, Seoul, Korea; Literary Arts, Brown University, Providence, RI.
authors.forename: Il Min
authors.initials: IM
authors.lastname: Ahn
authors.affiliation: Departments of Anesthesiology and Pain Medicine, Ilsan Paik Hospital, Inje University, Goyang, Korea.
authors.forename: Won Joo
authors.initials: WJ
authors.lastname: Choe
authors.affiliation: Anesthesiology and Pain Medicine, Korea University Medical Center, Seoul, Korea.
authors.forename: Choon-Hak
authors.initials: CH
authors.lastname: Lim
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects*; D014943:Global Health; D006331:Heart Diseases / Q000601:surgery; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic; D017693:Sodium Bicarbonate / Q000627:therapeutic use*
chemical_list: D017693:Sodium Bicarbonate
keywords: acute kidney injury; cardiac surgery; sodium bicarbonate