Bicarbonate vs. Saline for Preventing Contrast-Induced Nephropathy

In a randomized study, bicarbonate plus N-acetylcysteine was no more effective than saline plus N-acetylcysteine.

Hydration, with or without sodium bicarbonate, and administration of N-acetylcysteine (NAC) have both been shown to reduce the risk for contrast-induced nephropathy (CIN). In this prospective, randomized study involving 502 patients with creatinine clearances <60 mL per minute who underwent planned angiographic procedures, investigators compared saline infusion (1 mL/kg/hour for 12 hours before and after the procedure) with sodium bicarbonate infusion (154 mEq/L infused at 3 mL/kg for 1 hour before the procedure and at 1 mL/kg/hour for 6 hours after it). All patients also received oral NAC (600 mg twice daily from the day before through the day after contrast exposure).

Increases in serum creatinine concentrations from baseline to peak were …

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)