Open AccessSodium bicarbonate versus isotonic saline solution to prevent contrast-induced nephropathy : a systematic review and meta-analysis
Author(s) -
Carlos Andres Zapata-Chica,
Diana Bello Marquez,
Lina María Serna-Higuita,
John Fredy Nieto-Ríos,
Fabián David Casas-Arroyave,
Jorge Hernando Donado-Gómez
Publication year - 2015
Publication title -
colombia medica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.455
H-Index - 18
eISSN - 1657-9534
pISSN - 0120-8322
DOI - 10.25100/cm.v46i3.1925
Subject(s) - sodium bicarbonate , medicine , contrast induced nephropathy , saline , nephropathy , isotonic saline , meta analysis , urology , acute kidney injury , sodium , bicarbonate , renal replacement therapy , endocrinology , diabetes mellitus , chemistry , organic chemistry
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.Methods: A systematic review of studies registered in the Cochrane, Pubmed, Medline, Lilacs, ScielO and Embase databases was conducted. Randomized controlled studies that evaluated the use of 0.9% saline solution vs. sodium bicarbonate to prevent contrast-induced nephropathy were included.Results: A total of 22 studies (5,686 patients) were included. Sodium bicarbonate did not decrease the risk of contrast-induced nephropathy (RD= 0.00; 95% CI= -0.02 to 0.03; p= 0.83; I2= 0%). No significant differences were found in the demand for renal replacement therapy (RD= 0.00; 95% CI= -0.01 to 0-01; I2= 0%; p= 0.99) or in mortality (RD= -0.00; 95% CI= -0.001 to 0.001; I2= 0%; p= 0.51).Conclusions: Sodium bicarbonate administration is not superior to the use of 0.9% saline solution for preventing contrast-induced nephropathy in patients with risk factors, nor is it better at reducing mortality or the need for renal replacement therapy.