Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Clinical Investigation
Sodium Bicarbonate Improves Long-Term Clinical Outcomes Compared With Sodium Chloride in Patients With Chronic Kidney Disease Undergoing an Emergent Coronary Procedure
Masaharu Masuda, Takahisa Yamada, Yuji Okuyama, Takashi Morita, Shoji Sanada, Yoshio Furukawa, Yasumasa Tsukamoto, Keiji Okuda, Yuusuke Iwasaki, Taku Yasui, Masatake Fukunami
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Keywords: Contrast-induced nephropathy, Contrast media, Sodium bicarbonate
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2008 Volume 72 Issue 10 Pages 1610-1614

View "Advance Publication" version (August 29, 2008).
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Abstract

Background Contrast-induced nephropathy is associated with increased in-hospital and long-term adverse clinical outcomes. Methods and Results To investigate whether hydration with sodium bicarbonate improves long-term clinical outcomes compared with sodium chloride, patients with chronic kidney disease undergoing an emergent coronary procedure were enrolled in a randomized clinical trial with ≥1 year of follow-up. The 59 patients with chronic kidney disease (serum creatinine concentration >1.1 mg/dl or estimated glomerular filtration rate <60 ml/min) were randomly assigned to receive a 154 mmol/L intravenous infusion of either sodium bicarbonate (n=30) or sodium chloride (n=29). The electrolytes were given as a bolus of 3 ml ·kg-1 · h-1 for 1 h before the administration of contrast, followed by an infusion of 1 ml ·kg-1 · h-1 for 6 h during and after the procedure. During a mean follow-up period of 15.9±4.5 months, the incidence of renal replacement therapy or death was significantly lower in the sodium bicarbonate group than in the sodium chloride group (3% vs 21%, respectively; p=0.037). Conclusions Hydration with sodium bicarbonate reduces the incidence of renal replacement therapy and death in patients with chronic kidney disease undergoing an emergent coronary procedure. (Circ J 2008; 72: 1610 - 1614)

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© 2008 THE JAPANESE CIRCULATION SOCIETY
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