Intravenous Sodium Bicarbonate and Oral N-acetylcysteine for the Prevention of Contrast-Induced Nephropathy / 대한내과학회지
Korean Journal of Medicine
;
: 537-545, 2011.
Article
in Korean
| WPRIM
| ID: wpr-68591
ABSTRACT
BACKGROUND/AIMS:
The value of hydration with sodium bicarbonate and N-acetylcysteine (NAC) in the prevention of radiocontrast-induced nephropathy is questionable. This study investigated whether sodium bicarbonate hydration with or without NAC has a more protective role in the prevention of radiocontrast-induced nephropathy than saline hydration with or without NAC.METHODS:
We prospectively studied 100 patients with significant proteinuria (> or = 500 mg/d), azotemia (serum creatinine > or = 1.5 mg/dL), or diabetes mellitus who were undergoing coronary angiography using iodixanol, a nonionic iso-osmolar contrast agent. Patients were assigned randomly to receive saline infusion (S, n = 24), saline infusion plus NAC (S + NAC, n = 20), sodium bicarbonate infusion (B, n = 25), and sodium bicarbonate plus NAC (B + NAC, n = 31). Contrast-induced nephropathy was defined as an increase of 25% or more in the serum creatinine within 48 hours of contrast exposure.RESULTS:
There were no significant group differences in age, sex, and basal serum creatinine. Contrast-induced nephropathy occurred in 20 patients (20%) and its incidence was not significantly different among the groups; four from group S, five from group S + NAC, five from group B, and six from group B + NAC. The incidences were not significantly different when compared between S and B, irrespective of the use of NAC (21 vs. 20%), and when compared according to the presence of pre-existing azotemia (19 vs. 20%).CONCLUSIONS:
The efficacy of sodium bicarbonate hydration in the prevention of contrast-induced nephropathy seems comparable to that of saline hydration, and it was not improved by the addition of NAC.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Proteinuria
/
Acetylcysteine
/
Sodium
/
Triiodobenzoic Acids
/
Sodium Chloride
/
Incidence
/
Prospective Studies
/
Coronary Angiography
/
Sodium Bicarbonate
/
Contrast Media
Type of study:
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
Korean
Journal:
Korean Journal of Medicine
Year:
2011
Type:
Article
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