Intravenous Sodium Bicarbonate and Oral N-acetylcysteine for the Prevention of Contrast-Induced Nephropathy / 대한내과학회지
Korean Journal of Medicine
;
: 537-545, 2011.
Artigo
em Coreano
| 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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Proteinúria
/
Acetilcisteína
/
Sódio
/
Ácidos Tri-Iodobenzoicos
/
Cloreto de Sódio
/
Incidência
/
Estudos Prospectivos
/
Angiografia Coronária
/
Bicarbonato de Sódio
/
Meios de Contraste
Tipo de estudo:
Estudo de incidência
/
Estudo observacional
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Coreano
Revista:
Korean Journal of Medicine
Ano de publicação:
2011
Tipo de documento:
Artigo
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