Sodium Bicarbonate Therapy for Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-analysis

Prevenção de nefrotoxicidade por contraste com solução de bicarbonato: resultados preliminares e revisão da literatura

“…Likewise, the meta-analyses strongly suggest that the use of sodium bicarbonate be beneficial. [60][61][62][63][64][65] The most frequently used controls were infusion of saline solution isolated or in association with N-acetyl cysteine. [60][61][62][63][64][65] It is worth noting that the use of sodium bicarbonate showed no efficacy in decreasing mortality or need for dialysis.…”

“…[60][61][62][63][64][65] The most frequently used controls were infusion of saline solution isolated or in association with N-acetyl cysteine. [60][61][62][63][64][65] It is worth noting that the use of sodium bicarbonate showed no efficacy in decreasing mortality or need for dialysis. [63][64][65] The use of sodium bicarbonate may have selected the most severely ill patients, by preventing nephrotoxicity in those less severely ill.…”

“…The authors have concluded that hydration with sodium bicarbonate reduced the incidence of CN in comparison with hydration with normal saline. 63 Meier The authors have concluded that sodium bicarbonate-based hydration was superior to normal saline in preventing CN. 64 Kanbay et al have defined CN as an absolute (≥ 0.5 mg/dL) or relative (≥ 25%) increase in creatinine levels.…”

“…65 Thus, several meta-analyses have suggested that sodium bicarbonate-based hydration is superior to saline solution in preventing CN, as shown in Table 1. [60][61][62][63][64][65] A recent meta-analysis assessing ten studies has shown conflicting results with the use of N-acetyl cysteine and hydration with sodium bicarbonate * 7 studies ≥ 25%; 2 studies ≥ 0.5 mg/dL; 6 studies ≥ 25% and/or ≥ 0.5 mg/dL. ** most studies.…”

“…Number of studies RR bicarbonate versus saline Kanbay et al 65 ≥ 0.5 mg/dL ou ≥ 25% 17 0.54 (95% CI; 0.36-0.83) Meier et al 64 Several* 17 0.52 (95% CI; 0.34 -0.80) Joannidis et al 60 Not defined 9 0.45 (95% CI; 0.26 -0.79) Navaneethan 63 Not defined 12 0.46 (95% CI; 0.26 -0.82) Ho et al 62 ≥ 25% 8 0.22 (95% CI; 0.11 -0.44) Hogan et al 61 ≥ 25%** 7 0.37 (95% CI; 0.18 -0.714) Table 1 Meta-analyses of contrast-indUced nephropathy prevention coMparing the Use of bicarbonate and saline solUtion when compared with the use of N-acetyl cysteine and hydration with saline solution, depending on the definition of CN adopted. When defining CN as the 25% increase in baseline creatinine in 72 hours, the combination of N-acetyl cysteine and sodium bicarbonate showed no significant decrease in the incidence of CN, compared with the group receiving N-acetyl cysteine and saline solution.…”