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bicarbonate contrast induced nephropathy

Sadegh Ali-Hassan-Sayegh, Seyed Jalil Mirhosseini, Zahra Ghodratipour, Zahra Sarrafan-Chaharsoughi, Elham Rahimizadeh, Ali Akbar Karimi-Bondarabadi, Fatemeh Haddad, Arezoo Shahidzadeh, Parisa Mahdavi, Ali-Mohammad Dehghan, Mahbube Tahernejad, Azadeh Shahidzadeh, Hamidreza Dehghan, Azam Ghanei, Mohammadreza Lotfaliani, Alexander Weymann, Mohamed Zeriouh, Aron-Frederik Popov, Anton Sabashnikov
This systematic review with meta-analysis sought to determine the strength of evidence for the effects of hydration (sodium bicarbonate [SB] and normal saline [NS]), supplementations (N-acetylcysteine [NAC] and vitamin C), and some common drugs (adenosine antagonists [AAs], statins, loop diuretics, and angiotensin-converting enzyme inhibitors [ACEIs]) on the incidence of contrast-induced nephropathy (CIN) and requirement for hemodialysis after coronary angiography. After screening, a total of 125 trials that reported outcomes were identified...
August 1, 2016: Angiology
Suleyman Turedi, Erkan Erdem, Yunus Karaca, Ozgur Tatli, Aynur Sahin, Suha Turkmen, Abdulkadir Gunduz
STUDY OBJECTIVE: To compare the protective effects of N-acetylcysteine (NAC) plus normal saline (NS), sodium bicarbonate (NaHCO3) plus NS and NS alone in the prevention of contrast-induced nephropathy (CIN) after computed tomography pulmonary angiography (CTPA) in emergency patients. MATERIALS AND METHODS: This study was planned as a randomized, controlled clinical research. Patients undergoing contrast-enhanced CTPA on suspicion of pulmonary embolism (PE) in the emergency department and with at least one risk factor for development of CIN were included in one of three different prophylaxis groups...
July 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Shi-Jie Zhao, Zhao-Shuang Zhong, Guo-Xian Qi, Wen Tian
BACKGROUND: The efficacy of combining use of N-acetylcysteine (NAC) and sodium bicarbonate (SOB) in the prevention of contrast-induced nephropathy (CIN) after cardiac catheterization and percutaneous coronary intervention (PCI) is unclear. METHODS: All relevant studies that compared the effect of combining the use of NAC and SOB with individual use on CIN in patients undergoing cardiac catheterization and PCI were identified by searching the databases including Pubmed, Embase, Cochrane Library, and Web of Science without time and language limitation...
October 15, 2016: International Journal of Cardiology
Wolfgang Huber, Toni Huber, Stephan Baum, Michael Franzen, Christian Schmidt, Thomas Stadlbauer, Analena Beitz, Roland M Schmid, Sebastian Schmid
In this study, we investigated whether hydration with sodium bicarbonate is superior to hydration with saline in addition to theophylline (both groups) in the prophylaxis of contrast-induced nephropathy (CIN). It was a prospective, randomized, double-blinded study in a university hospital on 2 general intensive care units (63% of investigations) and normal wards.After approval of the local ethics committee and informed consent 152 patients with screening serum creatinine ≥1.1 mg/dL and/or at least 1 additional risk factor for CIN undergoing intravascular contrast media (CM) exposure were randomized to receive a total of 9 mL/kg bicarbonate 154 mmol/L (group B; n = 74) or saline 0...
May 2016: Medicine (Baltimore)
Sameh Mohamed Abouzeid, Hossam E ElHossary
Contrast-induced nephropathy (CIN) is one of the important complications of radiographic procedures, especially in patients with chronic kidney disease. It is also one of the common causes of acute kidney injury. The pathogenesis is postulated to be the effect of oxygen- free radicals and hyperosmolar stress on the renal medulla. It is reported that the production of superoxide is most active at acid environment. K/Na citrate is well known as a urine alkalinization medium, and this has been evaluated earlier with standard hydration for reduction of CIN and was stated to be efficient...
May 2016: Saudi Journal of Kidney Diseases and Transplantation
Sameh Abouzeid, Osama Mosbah
INTRODUCTION: The rapid decline in renal function caused by radiographic contrast agents usually is transient, but it can result in chronic kidney disease. The pathophysiology of contrast-induced nephropathy (CIN) is poorly understood, but it may include acute hypoxia-induced oxidative stress and free radicals generated within the acid environment of the renal medulla. Thus, the alkalization of urine by sodium bicarbonate has been regarded as resulting in the reduction of CIN. The aim of this study was to determine whether a long-duration sodium bicarbonate regimen is more effective than a short-duration regimen in reducing CIN...
February 2016: Electronic Physician
Soo Hwan Park, Myung Ho Jeong, In Hyae Park, Jin Soo Choi, Jung Ae Rhee, In Soo Kim, Min Cheol Kim, Jae Yeong Cho, Doo Sun Sim, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
BACKGROUND: Acute myocardial infarction (AMI) is a risk factor for contrast-induced nephropathy (CIN). We investigated whether pretreatment with statin, N-acetylcysteine (NAC) and sodium bicarbonate (NaHCO3) reduces the risk of CIN. METHODS: We conducted a prospective trial and enrolled a total of 334 ST-segment elevation myocardial infarction (STEMI) patients. Patients were divided into four groups: Group I (statin 40mg), Group II (statin 80mg), Group III (statin 80mg plus NAC 1200mg) and Group IV (regimen of group III plus NaHCO3 154mEq/L)...
June 1, 2016: International Journal of Cardiology
Heejung Choi, Yoonjung Kim, Soo Min Kim, Junam Shin, Hye Ryoun Jang, Jung Eun Lee, Wooseong Huh, Yoon-Goo Kim, Ha Young Oh, Dae Joong Kim
BACKGROUND: The purpose of this study was to evaluate the incidence of contrast-induced nephropathy (CIN), and the effect of intravenous albumin for prophylaxis of CIN in patients with liver cirrhosis (LC) and chronic kidney disease (CKD). METHODS: We conducted a retrospective study of 81 subjects with LC and CKD (estimated glomerular filtration rate (eGFR)<60 mL/min/1.73 m(2)) who underwent contrast-enhanced computed tomography (CT). Patients received either isotonic sodium bicarbonate solution (3 mL/kg for 1 h before CT and 1 mL/kg/h for 6 h after CT) or albumin (20% albumin, 25 mL for 1 h before CT and 75 mL for 6 h after CT)...
June 2012: Kidney Research and Clinical Practice
Rathan M Subramaniam, Catalina Suarez-Cuervo, Renee F Wilson, Sharon Turban, Allen Zhang, Cheryl Sherrod, Jonathan Aboagye, John Eng, Michael J Choi, Susan Hutfless, Eric B Bass
BACKGROUND: N-acetylcysteine, sodium bicarbonate, statins, and ascorbic acid have been studied for reducing contrast-induced nephropathy (CIN). PURPOSE: To evaluate the comparative effectiveness of interventions to reduce CIN in adults receiving contrast media. DATA SOURCES: MEDLINE, EMBASE, Cochrane Library,, and Scopus databases through June 2015. Risk of bias and overall strength of evidence (SOE) of studies were assessed...
March 15, 2016: Annals of Internal Medicine
Nicole Lefel, Loes Janssen, Jos le Noble, Norbert Foudraine
BACKGROUND: Intravenously administered iodine-containing contrast medium (CM) is associated with the development of contrast-induced nephropathy (CIN). Data on the effectiveness of sodium bicarbonate therapy in the prevention of CIN are controversial. Furthermore, the incidence of and risk factors for CIN in intensive care unit (ICU) patients are poorly defined. We investigated the effectiveness of sodium bicarbonate prophylaxis and the incidence of and risk factors for CIN in a heterogeneous ICU population...
2016: Journal of Intensive Care
Carlos Andres Zapata-Chica, Diana Bello Marquez, Lina Maria Serna-Higuita, John Fredy Nieto-Ríos, Fabian David Casas-Arroyave, Jorge Hernando Donado-Gómez
INTRODUCTION: Contrast-induced nephropathy is one of the main causes of acute kidney injury and increased hospital-acquired morbidity and mortality. The use of sodium bicarbonate for nephroprotection has emerged as a preventative strategy; however, its efficacy is controversial compared to other strategies, such as hydration using 0.9% saline solution. OBJECTIVE: To compare the effectiveness of sodium bicarbonate vs. hydration using 0.9% saline solution to prevent contrast-induced acute kidney injury...
July 2015: Colombia Médica: CM
Eric Chong, Kian-Keong Poh, Qingshu Lu, James Jun-Jie Zhang, Ning Tan, Xu Min Hou, Hean-Yee Ong, Aizai Azan, Shao-Liang Chen, Ji-Yan Chen, Rosli Mohd Ali, Wei-Yi Fang, Titus Wai Leong Lau, Huay-Cheem Tan
INTRODUCTION: N-acetylcysteine (NAC) and sodium bicarbonate (SOB) therapies may prevent contrast-induced nephropathy (CIN). However, the efficacy of using combination over individual therapies was not established, and there was no large randomised study comparing abbreviated SOB therapy with conventional sustained saline pre-hydration with oral NAC. METHODS: In a multi-centre, open-label, randomised, controlled trial (NCT00497328), we prospectively enrolled 548 patients with at least moderate renal impairment undergoing cardiac catheterisation with or without percutaneous coronary intervention...
December 15, 2015: International Journal of Cardiology
Richard Solomon, Paul Gordon, Steven V Manoukian, J Dawn Abbott, Dean J Kereiakes, Allen Jeremias, Michael Kim, Harold L Dauerman
BACKGROUND AND OBJECTIVES: Sodium bicarbonate has been proposed for protection of the kidney from contrast-induced AKI (CIAKI). However, the effects of bicarbonate on long-term important clinical outcomes are uncertain. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In a prospective, double-blind, multicenter randomized clinical trial, 391 patients with an eGFR<45 ml/min per 1.73 m(2) undergoing elective coronary or peripheral angiography were randomized to an infusion with a high dose of isotonic sodium bicarbonate (target 2...
September 4, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Sadegh Ali-Hassan-Sayegh, Seyed Jalil Mirhosseini, Elham Rahimizadeh, Zahra Ghodratipour, Zahra Sarrafan-Chaharsoughi, Ali Mohammad Dehghan, Mohammad Reza Lotfaliani, Mohammad Rezaeisadrabadi, Elham Kayvanpour, Farbod Sedaghat-Hamedani, Mohamed Zeriouh, Alexander Weymann, Anton Sabashnikov, Aron-Frederik Popov
This systematic review with meta-analysis sought to determine comparison of efficacy and safety of hydration with sodium bicarbonate versus sodium chloride on contrast induced nephropathy and clinical outcomes. We searched major electronic databases for studies in randomized controlled trials. A value of P < 0.1 for Q test or I (2) > 50% indicated significant heterogeneity between the studies. Literature search of all databases retrieved 650 studies. 29 studies enrolled in meta-analysis. Pooled analysis indicated about the incidence of CIN (OR of 0...
2015: Cardiology Research and Practice
Motonobu Nakamura, Nobuhiko Satoh, Masashi Suzuki, Haruki Kume, Yukio Homma, George Seki, Shoko Horita
Our previous study indicates that hyperinsulinemia in metabolic syndrome in the absence of nephropathy may promote hypertension by stimulating renal proximal tubule (PT) sodium transport via insulin receptor substrate (IRS) 2/phosphoinositide 3-kinase pathway. In the present study we showed that the stimulatory effect of insulin on the Na(+)-HCO3(-) cotransporter NBCe1 in isolated PTs was completely preserved in type 2 diabetic rats with overt nephropathy. Furthermore, the IRS2 expression and insulin-induced Akt phosphorylation in kidney cortex were preserved in these rats...
May 22, 2015: Biochemical and Biophysical Research Communications
Bin Zhang, Long Liang, Wenbo Chen, Changhong Liang, Shuixing Zhang
OBJECTIVE: The aim of this meta-analysis was to explore the efficacy of sodium bicarbonate in preventing contrast-induced nephropathy (CIN). METHODS: We searched PubMed, Medline and the Cochrane Library from 1 January 2004 to 1 August 2014. The effect estimate was expressed as a pooled OR with 95% CI, using the fixed-effects or random-effects model. RESULTS: 20 randomised controlled trials (n=4280) were identified. Hydration with sodium bicarbonate was associated with a significant decrease in CIN among patients with pre-existing renal insufficiency (OR 0...
2015: BMJ Open
Maen D Abou Ziki, Mohamud A Verjee
SLC26A3, a chloride/bicarbonate transporter mainly expressed in the intestines, plays a pivotal role in chloride absorption. We present a 23-year-old woman with a history of congenital chloride diarrhoea (CCD) and renal transplant who was admitted for rehydration and treatment of acute kidney injury after she presented with an acute diarrhoeal episode. Laboratory investigations confirmed metabolic alkalosis and severe hypochloraemia, consistent with her underlying CCD. This contrasts with most other forms of diarrhoea, which are normally associated with metabolic acidosis...
2015: BMJ Case Reports
Mohammad Reza Yeganehkhah, Leili Iranirad, Farshad Dorri, Soheila Pazoki, Hossein Akbari, Masoumeh Miryounesi, Mostafa Vahedian, Azam Nazeri, Fatemeh Hosseinzadeh, Jamshid Vafaeimanesh
Contrast-induced nephropathy is the third most common cause of acute renal failure in hospitalized patients. The purpose of this study was to compare three supportive treatments for prevention of contrast-induced nephropathy in high-risk patients undergoing coronary angiography. In this randomized clinical trial study, 150 patients with at least one risk factor, such as, congestive heart failure, history of diabetes mellitus, age>65 years or renal failure were randomly assigned to three equal groups: First group (Sodium (Na) bicarbonate infusion), second group [(N-Acetylcysteine (NAC)+Sodium Chloride (Nacl)], third group (Nacl)...
November 2014: Saudi Journal of Kidney Diseases and Transplantation
John Fredy Nieto-Ríos, Wílmar Arley Maya Salazar, Oscar Mauricio Santos Sánchez, Janeth Liliana Jaramillo Ortega, Jorge Ignacio García Caro, Julián Miguel Aristizabal Aristizabal, Lina Maria Serna Higuita, Álvaro García García, Fabián Alberto Jaimes Barragán
INTRODUCTION: Contrast-induced nephropathy is a common complication of radiographic procedures. Different measures have been used to avoid this damage, but the evidence is controversial. New investigations are required to clarify it. We investigated the efficacy and safety of sodium bicarbonate solution compared with sodium chloride solution to prevent contrast induced nephropathy in patients with or at risk of renal dysfunction. METHODS: A prospective, single-center, randomized clinical trial conducted from May 1, 2007 to February 8, 2008...
July 2014: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
Helmut Schiffl
The best "treatment" of acute kidney injury (AKI) is prevention. Patients who are at high risk of AKI should have an assessment of their volume status and receive appropriate volume expansion. The most effective type of intravenous fluid remains unclear. Innumerable studies have compared sodium bicarbonate and isotonic saline and have combined fluid hydration with pharmacological interventions, particularly N-acetyl-cysteine. However, abundant systematic reviews and meta-analyses have provided conflicting conclusions and have recognized a significant degree of heterogeneity between studies and publication bias...
February 2015: International Urology and Nephrology
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