Prevention of Contrast-Induced Acute Kidney Injury: Is Simple Oral Hydration Similar To Intravenous? A Systematic Review of the Evidence

Hiremath, Swapnil; Akbari, Ayub; Shabana, Wael; Fergusson, Dean; Knoll, Greg

doi:10.1371/journal.pone.0060009

Cited by 75 publications

(47 citation statements)

References 39 publications

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“…Some studies indicate that sodium bicarbonate-based hydration is superior to sodium chloride in preventing CI-AKI [8]. Efficacy of oral hydration in CI-AKI prevention has not been well established [9]. …”

Section: Introductionmentioning

confidence: 99%

Comparison of Intravenous and Oral Hydration in the Prevention of Contrast-Induced Acute Kidney Injury in Low-Risk Patients: A Randomized Trial

Martín-Moreno

Varo²,

Martı́nez-Ansó

et al. 2015

Nephron

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Aims: Contrast-induced acute kidney injury (CI-AKI) is a common cause of renal failure. We evaluated the effectiveness of oral sodium citrate versus intravenous (IV) sodium bicarbonate for CI-AKI prophylaxis as well as their influence on kidney injury biomarkers. Material and Methods: A randomized, controlled, single-center study including 130 hospitalized patients (62.3% men), who were randomized to receive sodium bicarbonate (1/6 men, 3 ml/kg/h for 1 h; n = 43), oral sodium citrate (75 ml/10 kg divided into 4 doses; n = 43) or nonspecific hydration (n = 44) before contrast administration, was conducted. Serum creatinine and kidney injury biomarkers (cystatin C, neutrophil gelatinase-associated lipocalin, interleukin-8, F2-isoprostanes and cardiotrophin-1 [CT-1]) were assessed. Results: Incidence of CI-AKI was 9.2% with no differences found between hydration groups: 7.0% in sodium bicarbonate group, 11.6% in oral sodium citrate group and 9.1% in the nonspecific hydration group. Urinary creatinine and urinary CT-1/creatinine ratio decreased 4 h after contrast infusion (p < 0.001), but none of the biomarkers assessed were affected by the treatments. Conclusions: There were no differences in hydration with oral sodium citrate and IV sodium bicarbonate for the prophylaxis of CI-AKI. Therefore, oral hydration represents a safe, inexpensive and practical method for preventing CI-AKI in low-risk patients. No effect on biomarkers for kidney injury could be demonstrated.

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Section: Introductionmentioning

confidence: 99%

Comparison of Intravenous and Oral Hydration in the Prevention of Contrast-Induced Acute Kidney Injury in Low-Risk Patients: A Randomized Trial

Martín-Moreno

Varo²,

Martı́nez-Ansó

et al. 2015

Nephron

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“…These values were then categorized according to the levels of risk following the Guidelines for Contrast Administration from the American College of Radiology [8][9][10][11][12][13] We then calculated the number of patients whose level of risk was not accurately predetermined when their GFR was calculated using the PoCT creatinine value versus their IDMS value. Even though most of the patients' creatinine changed, the level of risk remained in the same category for 109 patients, 9 patients' risk category decreased, and 38 patients' risk category increased when using their i-Stat creatinine value versus their IDMS creatinine value.…”

Section: Resultsmentioning

confidence: 99%

The Accuracy of Point-of-Care Creatinine Testing in the Emergency Department

Moreno

Schwartz

Dvorkin³

2015

Advances in Emergency Medicine

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Objective. To determine the accuracy of Point-Of-Care testing (PoCT) creatinine values when compared to standard central laboratory testing (IDMS) and to demonstrate if and how a discrepancy could lead to improper risk stratification for contrast induced nephropathy (CIN). Methods. We conducted a descriptive retrospective chart review of patients seen in the Emergency Department of a single suburban, community, and academic medical center. We included patients who presented to the department between March 2013 and September 2014 who had blood samples analyzed by both PoCT and IDMS. Results. Mean IDMS creatinine values were 0.23 mg/dL higher when compared with i-Stat values. 95% of the time, the IDMS creatinine value was variable and ranged from −0.45 mg/dL to +0.91 mg/dL when compared to the i-Stat creatinine. When using i-Stat creatinine values to calculate GFR, 47 out of 156 patients had risk category variations compared to using the IDMS value. This affected 30.1% of the total eligible sample population (22.9% to 37.3% with 95% CI). Conclusion. We found a significant discrepancy between PoCT and IDMS creatinine values and found that this discrepancy could lead to improper risk stratification for CIN.

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“…and after PCIs. Recent clinical trials 14,45 have supported the use of oral fluids as an effective alternative to intravenous fluids. Teams were also innovative in developing hard stops in a patient's process of care by delaying a procedure if the patient had not received an adequate fluid bolus until the ordered fluid bolus was delivered.…”

Section: Discussionmentioning

confidence: 99%

Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety

Lambert

Chaisson

Horton

et al. 2017

Critical Care Nurse

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BACKGROUND Acute kidney injury due to contrast material occurs in 3% to 15% of the 2 million cardiac catheterizations done in the United States each year. OBJECTIVE To reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. METHODS Nurse leaders in the Northern New England Cardiovascular Disease Study Group, a 10-center quality improvement consortium in Maine, New Hampshire, and Vermont, formed a nursing task force to reduce acute kidney injury due to contrast material after cardiovascular interventional procedures. Data were prospectively collected January 1, 2007, through June 30, 2012, on consecutive nonemergent patients (n = 20 147) undergoing percutaneous coronary interventions. RESULTS Compared with baseline rates, adjusted rates of acute kidney injury among the 10 centers were significantly reduced by 21% and by 28% in patients with baseline estimated glomerular filtration rate less than 60 mL/min per 1.73 m2. Key qualitative system factors associated with improvement included use of multidisciplinary teams, standardized fluid orders, use of an intravenous fluid bolus, patient education about oral hydration, and limiting the volume of contrast material. CONCLUSIONS Standardization of evidence-based best practices in nursing care may reduce the incidence of acute kidney injury due to contrast material.

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Prevention of Contrast-Induced Acute Kidney Injury: Is Simple Oral Hydration Similar To Intravenous? A Systematic Review of the Evidence

Cited by 75 publications

References 39 publications

Comparison of Intravenous and Oral Hydration in the Prevention of Contrast-Induced Acute Kidney Injury in Low-Risk Patients: A Randomized Trial

Comparison of Intravenous and Oral Hydration in the Prevention of Contrast-Induced Acute Kidney Injury in Low-Risk Patients: A Randomized Trial

The Accuracy of Point-of-Care Creatinine Testing in the Emergency Department

Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety

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