- 著者
- Jae-Sik Jang Han-Young Jin Jeong-Sook Seo Tae-Hyun Yang Dae-Kyeong Kim Tae Hee Kim Sang-Hwa Urm Dong-Soo Kim Dong-Kie Kim Sang-Hoon Seol Doo-Il Kim Kyoung-Im Cho Bo-Hyun Kim Yong Hyun Park Hyung-Gon Je Jung-Min Ahn Won-Jang Kim Jong-Young Lee Seung-Whan Lee
- 出版者
- 日本循環器学会
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.76, no.9, pp.2255-2265, 2012 (Released:2012-08-24)
- 参考文献数
- 65
- 被引用文献数
- 39 73
Background: Sodium bicarbonate has been postulated to prevent contrast-induced acute kidney injury (CI-AKI) by various mechanisms, although the reports are conflicting. Methods and Results: We searched MEDLINE, EMBASE, and the Cochrane databases for randomized controlled trials that compared a sodium chloride with a sodium bicarbonate hydration regimen with regard to CI-AKI. Data across 19 clinical trials consisting of 3,609 patients were combined. Preprocedural hydration with sodium bicarbonate was associated with a significant decrease in the rate of CI-AKI (odds ratio [OR] 0.56; 95% confidence interval [CI] 0.36–0.86; P=0.008). Stratified analyses by the type of contrast medium suggested lower odds of CI-AKI with sodium bicarbonate in studies using low-osmolar contrast media (OR 0.40; 95% CI 0.23–0.71, P=0.002) compared with those using the iso-osmolar agents (OR 0.76; 95% CI 0.41–1.43; P=0.40). No significant difference in the rates of postprocedural death (OR 0.49; 95% CI 0.23–1.04; P=0.06) and the requirement for renal replacement therapy (OR 0.94; 95% CI 0.46–1.91; P=0.86) was observed. However, we found significant changes in serum bicarbonate and potassium levels after sodium bicarbonate infusion. Conclusions: This updated meta-analysis demonstrates that sodium bicarbonate-based hydration is superior to sodium chloride in preventing CI-AKI of patients undergoing exposure to iodinated contrast media. (Circ J 2012; 76: 2255–2265)