October 18, 2009

Sodium Bicarbonate for the Prevention of Contrast Induced-Acute Kidney Injury: A Systematic Review and Meta-analysis

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This meta-analysis examined the use of sodium bicarbonate vs sodium chloride for the prevention of contrast induced nephropathy. The authors detected significant heterogeneity that was largely explained by trial size and publication status. Among the large randomized trials, there was no benefit for hydration with sodium bicarbonate. Studies suggesting a benefit of sodium bicarbonate was limited to small trials of lower methodological quality.

Full text provided for Nephrology Now users by the American Society of Nephrology

Related Articles:

Acute Kidney Injury, Contrast Nephropathy
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  • Arthur Jamieson

    Based on this paper (and other evidence), I think the Nephrology community can focus on ensuring high risk patients are volume expanded prior to contrast exposure, without worrying too much about whether to use isotonic NaHCO3 solution or saline. Since saline is much simpler to use, this should be our default solution of choice.

    I think we need to remember that using isotonic NaHCO3 requires nursing or pharmacy to specially prepare the solution, which increases costs, delays initiation of treatment and runs the risk of medical error.