title: Sodium bicarbonate versus isotonic saline solution to prevent contrast-induced nephropathy : a systematic review and meta-analysis.
abstract: BACKGROUND
  Contrast-induced nephropathy is one of the main causes of acute kidney injury and increased hospital-acquired morbidity and mortality. The use of sodium bicarbonate for nephroprotection has emerged as a preventative strategy; however, its efficacy is controversial compared to other strategies, such as hydration using 0.9% saline solution.
  
  
  OBJECTIVE
  To compare the effectiveness of sodium bicarbonate vs. hydration using 0.9% saline solution to prevent contrast-induced acute kidney injury.
  
  
  METHODS
  A systematic review of studies registered in the COCHRANE, PUBMED, MEDLINE, LILACS, SCIELO and EMBASE databases was conducted. Randomized controlled studies that evaluated the use of 0.9% saline solution vs. sodium bicarbonate to prevent contrast-induced nephropathy were included.
  
  
  RESULTS
  A total of 22 studies (5,686 patients) were included. Sodium bicarbonate did not decrease the risk of contrast-induced nephropathy (RD= 0.00; 95% CI= -0.02 to 0.03; p= 0.83; I(2)= 0%). No significant differences were found in the demand for renal replacement therapy (RD= 0.00; 95% CI= -0.01 to 0-01; I(2)= 0%; p= 0.99) or in mortality (RD= -0.00; 95% CI= -0.001 to 0.001; I(2)= 0%; p= 0.51).
  
  
  CONCLUSIONS
  Sodium bicarbonate administration is not superior to the use of 0.9% saline solution for preventing contrast-induced nephropathy in patients with risk factors, nor is it better at reducing mortality or the need for renal replacement therapy.
authors.affiliation: Pediatric Nephrologist. The University of Antioquia, Medellin, Colombia .
authors.forename: Carlos Andres
authors.initials: CA
authors.lastname: Zapata-Chica
authors.affiliation: Pediatric Nephrologist. The University of Antioquia, Medellin, Colombia .
authors.forename: Diana
authors.initials: D
authors.lastname: Bello Marquez
authors.affiliation: Pediatric Nephrologist. Pablo Tobón Uribe Hospital, The University of Antioquia. Medellin, Colombia.
authors.forename: Lina Maria
authors.initials: LM
authors.lastname: Serna-Higuita
authors.affiliation: Nephrologist. Pablo Tobón Uribe Hospital, The University of Antioquia, Medellin, Colombia.
authors.forename: John Fredy
authors.initials: JF
authors.lastname: Nieto-Ríos
authors.affiliation: Anesthesiologist. The University of Antioquia. Medellin, Colombia.
authors.forename: Fabian David
authors.initials: FD
authors.lastname: Casas-Arroyave
authors.affiliation: Clinical Epidemiologist. Pablo Tobón Uribe Hospital, Medellin, Colombia.
authors.forename: Jorge Hernando
authors.initials: JH
authors.lastname: Donado-Gómez
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D017582:Renal Replacement Therapy / Q000706:statistics & numerical data; D012307:Risk Factors; D017693:Sodium Bicarbonate / Q000008:administration & dosage*; D012965:Sodium Chloride / Q000008:administration & dosage*
chemical_list: D003287:Contrast Media; D012965:Sodium Chloride; D017693:Sodium Bicarbonate
keywords: Contrast-induced nephropathy; acute kidney injury; sodium bicarbonate; sodium chloride