Contrast-induced nephropathy similar with sodium chloride or ...

Tag : sodium

MedWire News : Sodium bicarbonate is no better than sodium chloride atpreventing nephropathy induced by iodine contrast media in patientswith moderate-to-severe chronic kidney disease who are undergoingcoronary angiography, a trial suggests.
Animal models of renal failure and one randomized clinical trialhave suggested that hydration with sodium bicarbonate may preventcontrast-induced nephropathy, note the researchers in the Journal of the American Medical Association.
They explain that alkalinizing the tubular urine with sodiumbicarbonate infusion may attenuate free radical formation, leadingto less antioxidant injury and lower rates of contrast-inducednephropathy.
To investigate its effect in humans, the team randomly assigned 353patients with renal disease at a single center to 3 ml/kg sodiumchloride or sodium bicarbonate for 1 hour before coronaryangiography. These doses were decreased to 1.5 ml/kg per hourduring the procedure, and for 4 hours after its completion.
The primary endpoint of a 25% or greater decrease in estimatedglomerular filtration rate on days 1 through 4 after contrastexposure did not significantly differ, occurring in 14.6% of the178 patients receiving sodium chloride and 13.3% of the 175receiving sodium bicarbonate.
When measured as an absolute or percent increase in serumcreatinine level, the incidence of nephropathy did notsignificantly differ in the two treatment groups, the researchersreport.
"The results of this study suggest that there may be no significantdifference between periprocedural hydration with sodium chloride orsodium bicarbonate for the prevention of contrast-inducednephropathy," report Somjot Brar (Columbia University MedicalCenter, New York, USA) and colleagues.
They believe: "Any true difference between the hydration strategiesis likely to be small and not clinically significant."
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