A meta-analysis of 17 randomized trials has shown that treatment with sodium bicarbonate is the optimal strategy to prevent contrast-induced nephropathy (CIN) and is superior to normal saline. The research was published in the open access journal BMC Medicine.
The findings were the work of Hitinder Gurm, a the University of Michigan researcher, who collaborated with a team of international scientists to review a total of 2,633 patients in order to assess the effectiveness of saline versus sodium bicarbonate for the prevention of CIN.
According to Gurm, "Contrast agents are administered in millions of procedures annually worldwide. In the USA and Europe, contrast-induced nephropathy (CIN) is the third leading cause of acute renal failure in hospitalized patients, accounting for about 10 percent of hospital-acquired renal failure.
"Although CIN is generally limited to a transient decline of renal function, it cannot be regarded as a benign complication; as many as 30 percent of cases result in lasting kidney damage," he said.
The authors found that CIN occurred in 109 of the 1,327 patients treated with sodium bicarbonate and in 175 of the 1306 patients who received normal saline.
The exact mechanism of CIN is still unknown, but sodium bicarbonate is thought to prevent it by increasing the alkalinity of tubular fluid, thereby limiting free radical production, Gurm said.
Source: BMC Medicine