Sodium bicarbonate versus normal saline for protection against contrast nephropathy

Pooja Budhiraja, Zhao Chen, Mordecai Popovtzer

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Contrast-induced nephropathy (CIN) is a form of acute kidney injury and a significant source of morbidity and mortality. We defined CIN as an increase in serum creatinine (SCr) of 25% or more within 48 hours of receiving contrast. We retrospectively compared sodium bicarbonate with normal saline for prevention of CIN. One hundred and eighty-seven patients exposed to contrast during cardiac angiography, treated prophylactically either with sodium bicarbonate (n = 89) or with normal saline (n = 98), were studied. Baseline characteristics of both groups were similar in terms of age, amount of contrast, presence of diabetes mellitus, and use of furosemide and angiotensin-converting enzyme inhibitor. Patients in bicarbonate group had more severe renal disease with higher baseline SCr (1.58 ± 0.5 mg/dL vs. 1.28 ± 0.3 mg/dL, p = 0.001) and lower estimated glomerular filtration rate (eGFR, 51.06 ± 14.0 mL/min vs. 62.3±13.5 mL/min, p = 0.001) compared to the normal saline group. After the contrast exposure, there was significant drop in eGFR (6.4%) and increase in SCr (11.3%) in the normal saline group and no significant change in the bicarbonate group. Three patients (3.4%) in the bicarbonate group as opposed to 14 patients (14.3%) in the normal saline group developed CIN (p = 0.011). Two patients in the normal saline group and none in the bicarbonate group needed dialysis. There was no significant difference in serum creatinine at three-month follow-up in either group. The above findings suggest that hydration with intravenous sodium bicarbonate is more effective than normal saline in preventing contrast-induced nephropathy.

Original languageEnglish (US)
Pages (from-to)118-123
Number of pages6
JournalRenal Failure
Volume31
Issue number2
DOIs
StatePublished - Feb 2009

Fingerprint

Sodium Bicarbonate
Bicarbonates
Creatinine
Serum
Furosemide
Glomerular Filtration Rate
Angiotensin-Converting Enzyme Inhibitors
Acute Kidney Injury
Dialysis
Diabetes Mellitus
Angiography
Morbidity
Kidney
Mortality

Keywords

  • Angiogram
  • Cardiac catheterization
  • Contrast-induced nephropathy
  • Normal saline dialysis
  • Sodium bicarbonate

ASJC Scopus subject areas

  • Nephrology
  • Critical Care and Intensive Care Medicine

Cite this

Sodium bicarbonate versus normal saline for protection against contrast nephropathy. / Budhiraja, Pooja; Chen, Zhao; Popovtzer, Mordecai.

In: Renal Failure, Vol. 31, No. 2, 02.2009, p. 118-123.

Research output: Contribution to journalArticle

Budhiraja, Pooja ; Chen, Zhao ; Popovtzer, Mordecai. / Sodium bicarbonate versus normal saline for protection against contrast nephropathy. In: Renal Failure. 2009 ; Vol. 31, No. 2. pp. 118-123.
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abstract = "Contrast-induced nephropathy (CIN) is a form of acute kidney injury and a significant source of morbidity and mortality. We defined CIN as an increase in serum creatinine (SCr) of 25{\%} or more within 48 hours of receiving contrast. We retrospectively compared sodium bicarbonate with normal saline for prevention of CIN. One hundred and eighty-seven patients exposed to contrast during cardiac angiography, treated prophylactically either with sodium bicarbonate (n = 89) or with normal saline (n = 98), were studied. Baseline characteristics of both groups were similar in terms of age, amount of contrast, presence of diabetes mellitus, and use of furosemide and angiotensin-converting enzyme inhibitor. Patients in bicarbonate group had more severe renal disease with higher baseline SCr (1.58 ± 0.5 mg/dL vs. 1.28 ± 0.3 mg/dL, p = 0.001) and lower estimated glomerular filtration rate (eGFR, 51.06 ± 14.0 mL/min vs. 62.3±13.5 mL/min, p = 0.001) compared to the normal saline group. After the contrast exposure, there was significant drop in eGFR (6.4{\%}) and increase in SCr (11.3{\%}) in the normal saline group and no significant change in the bicarbonate group. Three patients (3.4{\%}) in the bicarbonate group as opposed to 14 patients (14.3{\%}) in the normal saline group developed CIN (p = 0.011). Two patients in the normal saline group and none in the bicarbonate group needed dialysis. There was no significant difference in serum creatinine at three-month follow-up in either group. The above findings suggest that hydration with intravenous sodium bicarbonate is more effective than normal saline in preventing contrast-induced nephropathy.",
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