Details

Autor(en) / Beteiligte

• Ueda, Hiromichi, MD
• Yamada, Takahisa, MD, PhD
• Masuda, Masaharu, MD
• Okuyama, Yuji, MD, PhD
• Morita, Takashi, MD, PhD
• Furukawa, Yoshio, MD, PhD
• Koji, Tanaka, MD
• Iwasaki, Yusuke, MD
• Okada, Takeshi, MD
• Kawasaki, Masato, MD
• Kuramoto, Yuki, MD
• Naito, Takashi, MD
• Fujimoto, Tadao, MD
• Komuro, Issei, MD, PhD
• Fukunami, Masatake, MD, PhD

Titel

Prevention of Contrast-Induced Nephropathy by Bolus Injection of Sodium Bicarbonate in Patients With Chronic Kidney Disease Undergoing Emergent Coronary Procedures

Ist Teil von

• The American journal of cardiology, 2011-04, Vol.107 (8), p.1163-1167

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2011

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• We conducted a prospective study to determine whether a bolus injection of sodium bicarbonate before emergent coronary procedures in patients with chronic kidney disease (CKD) might prevent contrast-induced nephropathy (CIN). We enrolled 59 patients with CKD, defined by a serum creatinine concentration of >1.1 mg/dl or an estimated glomerular filtration rate of <60 ml/min, who were scheduled at admission to undergo an emergent coronary procedure. The patients were randomized to receive a bolus intravenous injection of 154 mEq/L of sodium bicarbonate (n = 30) or sodium chloride (n = 29) at the dose of 0.5 ml/kg, before contrast administration, followed by infusion of 154 mEq/L sodium bicarbonate at 1 ml/kg/hour for 6 hours in both groups. The primary end point was the occurrence of CIN, defined as an increase by >25% or >0.5 mg/dl of the serum creatinine level within 2 days after the procedure. In the sodium bicarbonate group, the serum creatinine concentration remained unchanged within 2 days of contrast administration (from 1.32 ± 0.46 to 1.38 ± 0.60 mg/dl, p = 0.33). In contrast, it had increased in the sodium chloride group (1.51 ± 0.59 to 1.91 ± 1.19 mg/dl, p = 0.006). The incidence of CIN was significantly lower in the sodium bicarbonate group than in the sodium chloride group (3.3% vs 27.6%, p = 0.01). In conclusion, rapid alkalization by bolus injection of sodium bicarbonate was effective for the prevention of CIN in patients with CKD undergoing emergent procedures.