Neither Bicarbonate nor Acetylcysteine Improves Renal Outcomes After Coronary Angiography

Urinary alkalinization and acetylcysteine have been proposed as possible ways to minimize contrast-induced nephropathy (CIN) in patients who receive intra-arterial injections of iodinated contrast. In this multicenter study, researchers randomized about 5000 patients scheduled for angiography (primarily coronary) to receive periprocedural administration of intravenous sodium bicarbonate or saline and, additionally, to receive acetylcysteine or placebo. All patients had estimated glomerular filtration rates (GFRs) between 15 and 59 mL/minute/1.73 m², and all patients received iso-osmolar or low-osmolar agents.

The primary endpoint (90-day incidence of death, need for dialysis, or persistent increase in serum creatinine of ≥50% from baseline) …