Sodium Bicarbonate Plus Isotonic Saline Versus Saline for Prevention of Contrast-Induced Nephropathy in Patients Undergoing Coronary Angiography: A Randomized Controlled Trial

Risks and Complications of Coronary Angiography: Contrast Related Complications

“…In a meta-analysis, comparing saline and bicarbonate, it was shown that rise of serum creatinine in bicarbonate group is less than salin group, but in term of need to dialysis and death there was no difference between the two groups (Hogan etal., 2008).In the largest RCT comparing salin and bicarbonate, No differences between two groups was shown (Maioli etal., 2008). In another retrospective study including 7977 patients it was shown that the risk of CIN in sodium bicarbonate is significantly higher than salin group (From etal., 2008).We showed that addition of sodium bicarbonate to isotonic salin added no benefit to isotonic salin alone in preventing CIN (Vasheghani-Farahani etal., 2009).These controversial results and heterogeneity of studies make it difficult to be able to extract a conclusion that bicarbonate is even equal to salin in preventing CIN.…”

Sodium bicarbonate infusion for prevention of acute kidney injury: No evidence for superior benefit, but risk for harm?

“…Most of the recent published studies [23][24][25][26][27][28][29][30][31][32] found no superiority of intravenous sodium bicarbonate. Amazingly, a multicenter prospective randomized study comparing the efficacy of prophylactic use of saline infusion versus sodium bicarbonate infusion for the prevention of CIN in patients with diabetes mellitus undergoing coronary angiography and/or intervention found that prophylactic hydration with isotonic saline before coronary procedures may reduce the incidence of CIN in diabetic patients not selected according to renal function to a greater extent than sodium bicarbonate [33].…”

Guidelines on the use of iodinated contrast media in patients with kidney disease 2012: digest version

“…These 7 studies differ in design, and sodium bicarbonate-based hydration was concluded to be effective in 3 studies [118][119][120] and ineffective in 4 studies [121][122][123][124]. The 4 studies that concluded that the sodium bicarbonate-based hydration was ineffective included 2 studies conducted in the same institution around the same time.…”