Details

Autor(en) / Beteiligte

• Jang, Jae-Sik
• Jin, Han-Young
• Seo, Jeong-Sook
• Yang, Tae-Hyun
• Kim, Dae-Kyeong
• Kim, Tae Hee
• Urm, Sang-Hwa
• Kim, Dong-Soo
• Kim, Dong-Kie
• Seol, Sang-Hoon
• Kim, Doo-Il
• Cho, Kyoung-Im
• Kim, Bo-Hyun
• Park, Yong Hyun
• Je, Hyung-Gon
• Ahn, Jung-Min
• Kim, Won-Jang
• Lee, Jong-Young
• Lee, Seung-Whan

Titel

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

Ist Teil von

• Circulation Journal, 2012, Vol.76(9), pp.2255-2265

Ort / Verlag

Japan: The Japanese Circulation Society

Erscheinungsjahr

2012

Quelle

MEDLINE

Beschreibungen/Notizen

• Background: Sodium bicarbonate has been postulated to prevent contrast-induced acute kidney injury (CI-AKI) by various mechanisms, although the reports are conflicting. Methods and Results: We searched MEDLINE, EMBASE, and the Cochrane databases for randomized controlled trials that compared a sodium chloride with a sodium bicarbonate hydration regimen with regard to CI-AKI. Data across 19 clinical trials consisting of 3,609 patients were combined. Preprocedural hydration with sodium bicarbonate was associated with a significant decrease in the rate of CI-AKI (odds ratio [OR] 0.56; 95% confidence interval [CI] 0.36–0.86; P=0.008). Stratified analyses by the type of contrast medium suggested lower odds of CI-AKI with sodium bicarbonate in studies using low-osmolar contrast media (OR 0.40; 95% CI 0.23–0.71, P=0.002) compared with those using the iso-osmolar agents (OR 0.76; 95% CI 0.41–1.43; P=0.40). No significant difference in the rates of postprocedural death (OR 0.49; 95% CI 0.23–1.04; P=0.06) and the requirement for renal replacement therapy (OR 0.94; 95% CI 0.46–1.91; P=0.86) was observed. However, we found significant changes in serum bicarbonate and potassium levels after sodium bicarbonate infusion. Conclusions: This updated meta-analysis demonstrates that sodium bicarbonate-based hydration is superior to sodium chloride in preventing CI-AKI of patients undergoing exposure to iodinated contrast media.  (Circ J 2012; 76: 2255–2265)