edoc

Sodium chloride vs. sodium bicarbonate for the prevention of contrast medium-induced nephropathy : a randomized controlled trial

Klima, T. and Christ, A. and Marana, I. and Kalbermatter, S. and Uthoff, H. and Burri, E. and Hartwiger, S. and Schindler, C. and Breidthardt, T. and Marenzi, G. and Mueller, C.. (2012) Sodium chloride vs. sodium bicarbonate for the prevention of contrast medium-induced nephropathy : a randomized controlled trial. European heart journal : the journal of the European Society of Cardiology, Vol. 33, H. 16. pp. 2071-2079.

Full text not available from this repository.

Official URL: http://edoc.unibas.ch/dok/A6094379

Downloads: Statistics Overview

Abstract

AimsThe most effective regimen for the prevention of contrast-induced nephropathy (CIN) remains uncertain. Our purpose was to compare two regimens of sodium bicarbonate with 24 h sodium chloride 0.9% infusion in the prevention of CIN.Methods and resultsWe performed a prospective, randomized trial between March 2005 and December 2009, including 258 consecutive patients with renal insufficiency undergoing intravascular contrast procedures. Patients were randomized to receive intravenous volume supplementation with either (A) sodium chloride 0.9% 1 mL/kg/h for at least 12h prior and after the procedure or (B) sodium bicarbonate (166 mEq/L) 3 mL/kg for 1h before and 1 mL/kg/h for 6h after the procedure or (C) sodium bicarbonate (166 mEq/L) 3 mL/kg over 20min before the procedure plus sodium bicarbonate orally (500 mg per 10 kg). The primary endpoint was the change in estimated glomerular filtration rate (eGFR) within 48h after contrast. Secondary endpoints included the development of CIN. The maximum change in eGFR was significantly greater in Group B compared with Group A {mean difference -3.9 [95% confidence interval (CI), -6.8 to -1] mL/min/1.73 m(2), P = 0.009} and similar between Groups C and B [mean difference 1.3 (95% CI, -1.7-4.3) mL/min/1.73 m(2), P = 0.39]. The incidence of CIN was significantly lower in Group A (1%) vs. Group B (9%, P = 0.02) and similar between Groups B and C (10%, P = 0.9).ConclusionVolume supplementation with 24 h sodium chloride 0.9% is superior to sodium bicarbonate for the prevention of CIN. A short-term regimen with sodium bicarbonate is non-inferior to a 7 h regimen.ClinicalTrials.gov Identifier: NCT00130598
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Biostatistics
UniBasel Contributors:Schindler, Christian
Item Type:Article, refereed
Article Subtype:Research Article
Bibsysno:Link to catalogue
Publisher:Oxford University Press
ISSN:0195-668X
Note:Publication type according to Uni Basel Research Database: Journal article
Related URLs:
Identification Number:
Last Modified:19 Jul 2013 07:44
Deposited On:19 Jul 2013 07:42

Repository Staff Only: item control page