Neither Sodium Bicarbonate nor Oral Acetylcysteine Prevents Contrast-Induced Kidney Injury

A large randomized study fails to show benefit over saline hydration during angiography for two frequently used agents.

Most previous studies of sodium bicarbonate hydration and oral acetylcysteine for the prevention of contrast-induced acute kidney injury (AKI) have not shown clear benefit. With the relative safety of the agents and the concern that the studies were underpowered, however, their widespread use continued. The current researchers conducted a large, randomized, double-blind study with a 2×2 factorial design (PRESERVE; NCT01467466) in 4993 patients with chronic kidney disease (CKD; median creatinine, 1.5 mg/dL) who were scheduled to receive angiography. Patients had stage 3 or 4 CKD (stage 3A patients were required to have diabetes).

Study arms were intravenous sodium bicarbonate (vs. saline control) and oral acetylcysteine (vs. placebo). Most pa…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)