Comparison of Usefulness of Sodium Bicarbonate Versus Sodium Chloride to Prevent Contrast-Induced Nephropathy in Patients Undergoing an Emergent Coronary Procedure

Masuda, Masaharu; Yamada, Takahisa; Mine, Takanao; Morita, Takashi; Tamaki, Shunsuke; Tsukamoto, Yasumasa; Okuda, K; Iwasaki, Y; Hori, Miyuki; Fukunami, Masatake

doi:10.1016/j.amjcard.2007.03.098

Cited by 142 publications

(90 citation statements)

References 24 publications

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“…4 Sodium bicarbonate is another agent that has been demonstrated to exert preventive effects on CIN development by means of disrupting some pathways leading to free-radical formation. 21 Because of vasodilatory effects, some calcium channel blockers have been tried to prevent CIN. Unfortunately, most studies using these drugs as a prophylactic agent resulted in disappointment in the prevention of CIN.…”

Section: Discussionmentioning

confidence: 99%

Does Nebivolol Prevent Contrast‐Induced Nephropathy in Humans?

Günebakmaz

Kaya

Koç

et al. 2012

Clinical Cardiology

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Background:An experimental study showed that nebivolol is an effective agent in contrast‐induced nephropathy (CIN) prophylaxis.Hypothesis:We hypothesized that prophylactic nebivolol use had protective effects on renal function in human beings subjected to iodinated contrast agent since it has vasodilatory effect and antioxidant properties.Methods:The present study enrolled 120 patients scheduled for coronary angiography and ventriculography. All patients were hydrated with intravenous isotonic saline. The patients in group I received 600 mg N‐acetylcysteine every 12 hours for 4 days. The patients in group II received 5 mg nebivolol every 24 hours for 4 days. The patients in group III were only hydrated. The primary endpoint was the occurrence of CIN. The secondary endpoint was the change in serum creatinine (Cr) levels at 2 days and 5 days after the contrast exposure.Results:Nine (22.5%) patients in group I developed CIN, as did 8 patients (20.0%) in group II and 11 patients (27.5%) in group III (P = 0.72). Changes in mean Cr level from baseline to day 2 were not statistically significant in all groups. However, we detected a statistically significant increase in mean Cr levels at day 5 compared with baseline levels in group I and group III (from 1.42 ± 0.13 to 1.52 ± 0.26, p2 = 0.02; and from 1.43 ± 0.14 to 1.55 ± 0.30, p2 = 0.01, respectively). Although an increase was detected in mean Cr level from baseline to the 5‐day Cr level in group II, this did not reach statistical significance (from 1.40 ± 0.12 to 1.48 ± 0.23, P = 0.06).Conclusions:Pretreatment with nebivolol is protective against nephrotoxic effects of contrast media. © 2012 Wiley Periodicals, Inc.The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Section: Discussionmentioning

confidence: 99%

Does Nebivolol Prevent Contrast‐Induced Nephropathy in Humans?

Günebakmaz

Kaya

Koç

et al. 2012

Clinical Cardiology

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“…Some of these studies evaluated the use of sodium bicarbonate plus N-acetylcysteine 17,19,21,23 and, therefore, do not allow for a definitive conclusion regarding the benefit of isolated sodium bicarbonate in CIN prophylaxis, once the evaluation of two drugs simultaneously is an important confusion bias. Among studies that compared only sodium bicarbonate and saline solution, the results are also inconsistent 18,20,22 . The present study is the only multicenter and has the largest sample size among the studies that evaluated hydration with bicarbonate as a single approach for CIN prophylaxis.…”

Section: Discussionmentioning

confidence: 99%

“…Only one additional study evaluated the same bicarbonate protocol and showed superiority of bicarbonate. However, that was a single-center study and that included only 59 patients 20 .…”

Section: Discussionmentioning

confidence: 99%

“…Posterior studies evaluated sodium bicarbonate in the prevention of CIN in patients submitted to the angiography and/or PCI produced conflicting results [17][18][19][20][21][22][23] . Some of these studies evaluated the use of sodium bicarbonate plus N-acetylcysteine 17,19,21,23 and, therefore, do not allow for a definitive conclusion regarding the benefit of isolated sodium bicarbonate in CIN prophylaxis, once the evaluation of two drugs simultaneously is an important confusion bias.…”

Section: Discussionmentioning

confidence: 99%

“…However, there is limited and controversial data regarding assessing the efficacy of sodium bicarbonate in patients undergoing cardiac catheterization [17][18][19][20][21][22][23] .…”

Section: Introductionmentioning

confidence: 99%

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