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Sodium bicarbonate for the prevention of contrast-induced nephropathy: the efficacy of high concentration solution

Nozomu Tamai1, Shigenori Ito, Kosuke Nakasuka

  • 1Division of Cardiology, Nagoya City East Medical Center, Aichi, 464-8547 Japan. tamain04mfk@peace.ocn.ne.jp

The Journal of Invasive Cardiology
|September 8, 2012
PubMed

Insights

High-concentration sodium bicarbonate effectively prevents contrast-induced nephropathy (CIN) by increasing urine pH. This study found a higher concentration of sodium bicarbonate more effective for urine alkalization and CIN prevention in patients with renal dysfunction.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Contrast-induced nephropathy (CIN) is a significant risk for patients with renal dysfunction undergoing procedures like coronary angiography.
  • The optimal prophylactic dose of sodium bicarbonate to prevent CIN remains undetermined.
  • Sodium bicarbonate is a potential agent for CIN prophylaxis due to its urine alkalizing properties.

Purpose of the Study:

  • To evaluate the efficacy of high-concentration sodium bicarbonate in preventing CIN compared to a low concentration.
  • To assess the impact of different sodium bicarbonate concentrations on urine pH and renal function markers.

Main Methods:

  • A prospective study involving 123 patients with renal dysfunction undergoing coronary angiography.
  • Patients received either high-concentration (833 mEq/L) or low-concentration (160 mEq/L) sodium bicarbonate infusions.
  • Incidence of CIN, urine pH, serum creatinine, and estimated glomerular filtration rate were monitored.

Main Results:

  • High-concentration sodium bicarbonate significantly increased urine pH compared to low-concentration and control groups.
  • The incidence of CIN was significantly lower in the high-concentration group (0%) versus the low-concentration group (17.3%).
  • Patients receiving high-concentration sodium bicarbonate showed significantly lower percent change in creatinine and higher percent change in estimated glomerular filtration rate.

Conclusions:

  • Higher concentrations of sodium bicarbonate are more effective in achieving urine alkalization.
  • High-concentration sodium bicarbonate demonstrates superior efficacy in preventing contrast-induced nephropathy in at-risk patients.
  • This approach offers a promising strategy for mitigating CIN risk during contrast-enhanced procedures.
Abstract

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