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Randomized Trial of Bicarbonate or Saline Study for the Prevention of Contrast-Induced Nephropathy in Patients with CKD.

Author: , AbbottJ Dawn, DauermanHarold L, GordonPaul, JeremiasAllen, KereiakesDean J, KimMichael, ManoukianSteven V, SolomonRichard

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Overview

A prospective, double-blind, multicenter randomized clinical trial of 391 patients with an eGFR<45 ml/min per 1.73 m(2) undergoing elective coronary or peripheral angiography showed that high-dose sodium bicarbonate infusion did not demonstrate a difference in incidence of death, dialysis, or sustained 6-month reduction in eGFR or contrast-induced acute kidney injury (CIAKI) compared with sodium chloride.
Paper Details　
Original Abstract of the Article :
BACKGROUND AND OBJECTIVES: Sodium bicarbonate has been proposed for protection of the kidney from contrast-induced AKI (CIAKI). However, the effects of bicarbonate on long-term important clinical outcomes are uncertain. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a prospective, double-blind, ...See full text at original site
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引用元：
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559510/

データ提供：米国国立医学図書館（NLM）

Bicarbonate vs. Saline for Contrast-Induced Nephropathy: A Randomized Trial

The field of nephrology is constantly seeking new strategies to protect the kidneys from damage, particularly during medical procedures involving contrast agents. This research investigates the potential protective effects of sodium bicarbonate compared to sodium chloride in patients with chronic kidney disease (CKD) undergoing angiography. The researchers conducted a large-scale randomized clinical trial to compare the efficacy of these two solutions in preventing contrast-induced nephropathy (CIAKI). Their findings suggest that high-dose sodium bicarbonate infusion did not demonstrate a significant difference in preventing CIAKI or other adverse outcomes compared to sodium chloride.

Assessing the Protective Effects of Sodium Bicarbonate

The researchers found no significant difference in the incidence of CIAKI or the composite outcome of mortality, dialysis, or sustained reduction in eGFR between the bicarbonate and control groups. This finding challenges the previously held notion that bicarbonate may offer substantial protection against CIAKI.

Navigating Contrast Agent Risks in CKD

The study suggests that high-dose sodium bicarbonate may not be a reliable strategy for preventing CIAKI in patients with CKD undergoing angiography. This information is crucial for nephrologists and clinicians managing patients with CKD who require contrast-enhanced imaging. Just as a desert traveler must carefully choose their route to avoid treacherous terrain, clinicians must weigh the risks and benefits of different treatment approaches for their patients.

Dr. Camel's Conclusion

This research adds a layer of complexity to the landscape of nephrology, particularly in the context of contrast-induced nephropathy. The desert of CKD can be treacherous, and finding safe and effective ways to protect the kidneys is an ongoing quest. The study's findings highlight the importance of a comprehensive and nuanced approach to managing contrast agent risks in patients with CKD.

Date :
  1. Date Completed 2016-06-21
  2. Date Revised 2019-01-08
Further Info :

Pubmed ID

26185263

DOI: Digital Object Identifier

PMC4559510

Related Literature

Article Analysis
・Effects of sodium bicarbonate
SNS
PICO Info
in preparation
Languages

English

Positive IndicatorAn AI analysis index that serves as a benchmark for how positive the results of the study are. Note that it is a benchmark and requires careful interpretation and consideration of different perspectives.

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