Curriculum in CardiologyCurrent role of sodium bicarbonate–based preprocedural hydration for the prevention of contrast-induced acute kidney injury: A meta-analysis
Section snippets
Data sources and searches
Articles from January 1990 through October 2007 were identified using PubMed, MEDLINE, the Cochrane Central Register of Controlled Trials, International Pharmaceutical Abstracts database, and ISI Web of Knowledge. Internet-based sources of information, including www.tctmd.com and www.theheart.org, were also searched. Published abstracts were reviewed from the Proceedings of the Society for Cardiovascular Angiography and Interventions' 30th Annual Scientific Sessions, the American College of
Results
A total of 153 articles were reviewed, and 5 satisfied the predetermined inclusion criteria (Figure 1).20, 21, 22, 23, 24 One study by Schmidt et al25 was excluded because it was a retrospective trial. Two of the studies have not been published in peer-reviewed literature but were presented at the American College of Cardiology 2007 Scientific Session12 and the Transcatheter Therapeutics 2007 meeting26 and are published in abstract form. One study randomized patients to 3 arms: sodium
Discussion
In this meta-analysis of 7 RCTs, we found that preprocedural hydration with sodium bicarbonate significantly reduces the incidence of contrast-induced AKI compared with hydration with NS without decreasing the incidence of death or need for HD. There is, however, concern that these results are strongly influenced by publication bias, indicating the need for a large definitive RCT.
The health care implications of contrast-induced AKI cannot be overemphasized given its effects on patient morbidity
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