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Title: Sodium Bicarbonate Not Superior to Sodium Chloride for Hydration During Coronary Angiography to Prevent Kidney Problems
URL: http://www.pslgroup.com/dg/22A6A6.htm
Doctor's Guide
September 2, 2008

CHICAGO -- September 2, 2008 -- Use of sodium bicarbonate for hydration during coronary angiography for patients with kidney disease did not reduce the risk of developing serious kidney problems related to the use of contrast agents, compared to use of sodium chloride, according to a study in the September 3 issue of the Journal of the American Medical Association.

Somjot S. Brar, MD, Columbia University Medical Center, New York, New York, and colleagues conducted a study to evaluate the effect of sodium bicarbonate on the prevention of contrast medium-induced nephropathy.

The randomised, controlled trial included 353 patients with moderate to severe kidney disease who were undergoing coronary angiography. Patients were randomised to receive either sodium chloride (n = 178) or sodium bicarbonate (n = 175), administered before, during, and after coronary angiography. The median patient age was 71 years, and 45% of the patients had diabetes.

Overall, contrast-induced nephropathy assessed by estimated glomerular filtration rate occurred in 13.9% (45/323) of the patients. The group receiving sodium chloride hydration had a 14.6% (24/165) incidence versus 13.3% (21/158) in the sodium bicarbonate group.

In patients receiving sodium bicarbonate versus sodium chloride, the rates of death, dialysis, heart attack, and cerebrovascular events did not differ significantly at 30 days or at 30 days to 6 months.

"The results of this study do not suggest that hydration with sodium bicarbonate is superior to hydration with sodium chloride in patients with moderate to severe chronic kidney disease who are undergoing coronary angiography," the authors wrote.

"The overall incidence of contrast-induced nephropathy among patients was 13.9% and did not differ by treatment assignment. The frequency of clinical adverse events did not significantly differ between groups. Any true difference between the hydration strategies is likely to be small and not clinically significant."

SOURCE: Journal of the American Medical Association.

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