Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study) [documento electrónico] / John Fredy Nieto Ríos, ; Lina Maria Serna Higuita, ; Fabián Alberto Jaimes Barragán,  . - 2014.
Obra : Brazilian Journal of Nephrology

Idioma : Inglés (eng)

Palabras clave :	Acute kidney injury  contrast media  saline waters  sodium bicarbonate
Resumen :	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. Inpatients in a tertiary center, scheduled to undergo a procedure with the nonionic radiographic contrast agent iohexol. There were 220 patients with serum creatinine levels of at least 1.2 mg/dL (106.1 µmol/L) and/or type 2 diabetics, who were randomized to receive an infusion of sodium chloride (n = 113) or sodium bicarbonate (n = 107) before and after contrast dye administration. The intervention were "A" group received 1 ml/kg/hour of normal saline solution, starting 12 hours before and continuing 12 hours after iohexol contrast. "B" group received 3 ml/kg of sodium bicarbonate solution (150 mEq/L) one hour prior to procedure and then drip rate was decreased to 1 ml/kg/hour until 6 hours post procedure. Our main outcome measure was change in serum creatinine. Results: The mean creatinine value after the procedure was 1.26 mg/dL in the saline group and 1.22 mg/dL in the bicarbonate group (mean difference: 0.036; CI 95%: -0.16 to 0.23, p = 0.865). The diagnosis of contrast-induced nephropathy, defined by increase in serum creatinine on 25% or more within 2 days after administration of radiographic contrast, was done in twelve patients (12%) in the bicarbonate group and eighth patients (7.1%) in the saline group (RR: 1.68, CI 95%: 0.72 to 3.94). Conclusion: Our investigation showed that there were no differences between normal saline solution (extended infusion) vs. bicarbonate solution for nephroprotection.
Mención de responsabilidad :	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
Referencia :	J Bras Nefrol. 2014 Jul-Sep;36(3):360-6.
DOI (Digital Object Identifier) :	10.5935/0101-2800.20140051
PMID :	25317619
Derechos de uso :	CC BY
En línea :	http://www.bjn.org.br/details/1674/en-US/prevention-of-contrast-induced-nephropa [...]
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