Portal de Periódicos da CAPES

Efficacy of Single-Bolus Administration of Sodium Bicarbonate to Prevent Contrast-Induced Nephropathy in Patients With Mild Renal Insufficiency Undergoing an Elective Coronary Procedure

2009; Elsevier BV; Volume: 104; Issue: 7 Linguagem: Inglês

10.1016/j.amjcard.2009.05.034

1879-1913

Akira Tamura, Yukie Goto, Kumie Miyamoto, Shigeru Naono, Yoshiyuki Kawano, Munenori Kotoku, Toru Watanabe, Jun‐ichi Kadota,

Trauma, Hemostasis, Coagulopathy, Resuscitation

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 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. 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 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. Is Simpler Also Better? Brief Sodium Bicarbonate Infusion to Prevent Contrast-Induced NephropathyAmerican Journal of CardiologyVol. 105Issue 7PreviewWe read the report by Tamura et al1 comparing a single bolus of sodium bicarbonate with saline hydration to reduce the risk of contrast-induced nephropathy with interest. Their study not only adds to the increasing evidence that bicarbonate is an effective preventive treatment;2 more importantly, it is the first study evaluating the meaningful approach of single bolus bicarbonate application. Previous studies used nonuniform protocols, but most of them were based on 6- to 12-hour infusions before contrast application (and an additional 6 to 12 hours after contrast). Full-Text PDF