학술논문
Randomized trial of one-hour sodium bicarbonate vs standard periprocedural saline hydration in chronic kidney disease patients undergoing cardiovascular contrast procedures.
Document Type
article
Author
Judith Kooiman; Jean-Paul P M de Vries; Jan Van der Heyden; Yvo W J Sijpkens; Paul R M van Dijkman; Jan J Wever; Hans van Overhagen; Antonie C Vahl; Nico Aarts; Iris J A M Verberk-Jonkers; Harald F H Brulez; Jaap F Hamming; Aart J van der Molen; Suzanne C Cannegieter; Hein Putter; Wilbert B van den Hout; Inci Kilicsoy; Ton J Rabelink; Menno V Huisman
Source
PLoS ONE, Vol 13, Iss 2, p e0189372 (2018)
Subject
Language
English
ISSN
1932-6203
Abstract
Guidelines advise periprocedural saline hydration for prevention of contrast induced-acute kidney injury (CI-AKI). We analysed whether 1-hour sodium bicarbonate hydration administered solely prior to intra-arterial contrast exposure is non-inferior to standard periprocedural saline hydration in chronic kidney disease (CKD) patients undergoing elective cardiovascular diagnostic or interventional contrast procedures.We performed an open-label multicentre non-inferiority trial between 2011-2014. Patients were randomized to 1 hour pre-procedure sodium bicarbonate hydration (250 ml 1.4%, N = 168) or 4-12 hours saline hydration (1000 ml 0.9%, N = 165) prior to and following contrast administration (2000 ml of saline total). Primary outcome was the relative serum creatinine increase (%) 48-96 hours post contrast exposure. Secondary outcomes were: incidence of CI-AKI (serum creatinine increase>25% or >44μmol/L), recovery of renal function, the need for dialysis, and hospital costs within two months follow-up.Mean relative creatinine increase was 3.1% (95%CI 0.9 to 5.2%) in the bicarbonate and 1.1% (95%CI -1.2 to 3.5%) in the saline arm, mean difference 1.9% (95%CI -1.2 to 5.1%, p-non-inferiority