We sought to clarify whether a single-bolus intravenous administration of sodium bicarbonate
in addition to hydration with sodium chloride prevents contrast-induced nephropathy
(CIN). One hundred forty-four patients with mild renal insufficiency (serum creatinine
>1.1 to <2.0 mg/dl) undergoing an elective coronary procedure were randomly
assigned to the following 2 groups: standard hydration with sodium chloride plus singlebolus
intravenous administration of sodium bicarbonate (20 mEq) immediately before
contrast exposure (group A, n
72) and standard hydration alone (group B, n
72). The
primary end point was development of CIN, defined as an increase >25% or >0.5 mg/dl
in serum creatinine within 3 days after the procedure. Incidence of the primary end point
was lower in group A than in group B (1.4% vs 12.5%, p
0.017). Incidence of adverse
clinical events (acute pulmonary edema, acute renal failure requiring dialysis, and death
within 7 days of procedure) did not differ between the 2 groups (0% vs 1.4%). In conclusion,
single-bolus intravenous administration of sodium bicarbonate in addition to standard
hydration can more effectively prevent CIN than standard hydration alone in patients with
mild renal insufficiency undergoing an elective coronary procedure. © 2009 Elsevier Inc.
All rights reserved. (Am J Cardiol 2009;104:921–925)