title: Sodium Bicarbonate-Ascorbic Acid Combination for Prevention of Contrast-Induced Nephropathy in Chronic Kidney Disease Patients Undergoing Catheterization.
abstract: Sodium bicarbonate and ascorbic acid have been proposed to prevent contrast-induced nephropathy (CIN). The present study evaluated the effect of their combined use on CIN incidence.
  
  
  
  We prospectively enrolled 429 patients with chronic kidney disease (CKD: baseline estimated glomerular filtration rate <60 mL/min/1.73 m2) prior to elective coronary catheterization. CIN was defined as absolute (≥0.5 mg/dL) or relative (≥25%) increase in serum creatinine within 72 h. In the saline hydration (n=218) and combined sodium bicarbonate+ascorbic acid (n=211) groups, a total of 1,500-2,500 mL 0.9% saline was given before and after the procedure. In addition, the combination group received 20 mEq sodium bicarbonate and 3 g ascorbic acid i.v. before the procedure, followed by 2 g ascorbic acid after the procedure and a further 2 g after 12 h. There were no significant differences between the basic characteristics and contrast volume in the 2 groups. CIN occurred in 19 patients (8.7%) in the saline group, and in 6 patients (2.8%) in the combined treatment group (P=0.008).
  
  
  
  Combined sodium bicarbonate and ascorbic acid could prevent CIN following catheterization in CKD patients.
authors.affiliation: Department of Cardiology, Tokyo Metropolitan Hiroo Hospital.
authors.forename: Kota
authors.initials: K
authors.lastname: Komiyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Ashikaga
authors.forename: Dai
authors.initials: D
authors.lastname: Inagaki
authors.forename: Tomonori
authors.initials: T
authors.lastname: Miyabe
authors.forename: Marina
authors.initials: M
authors.lastname: Arai
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Yoshida
authors.forename: Satoshi
authors.initials: S
authors.lastname: Miyazawa
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakada
authors.forename: Iwanari
authors.initials: I
authors.lastname: Kawamura
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Masuda
authors.forename: Sho
authors.initials: S
authors.lastname: Nagamine
authors.forename: Rintaro
authors.initials: R
authors.lastname: Hojo
authors.forename: Yuya
authors.initials: Y
authors.lastname: Aoyama
authors.forename: Takaaki
authors.initials: T
authors.lastname: Tsuchiyama
authors.forename: Seiji
authors.initials: S
authors.lastname: Fukamizu
authors.forename: Takashi
authors.initials: T
authors.lastname: Shibui
authors.forename: Harumizu
authors.initials: H
authors.lastname: Sakurada
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001205:Ascorbic Acid / Q000627:therapeutic use*; D006328:Cardiac Catheterization; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009401:Nephrosis / Q000139:chemically induced / Q000517:prevention & control*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000628:therapy; D017693:Sodium Bicarbonate / Q000627:therapeutic use*
chemical_list: D003287:Contrast Media; D017693:Sodium Bicarbonate; D003404:Creatinine; D001205:Ascorbic Acid