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Sodium Bicarbonate Not a Superior Hydration Strategy

Outcomes are similar to sodium chloride in preventing contrast medium-induced nephropathy

TUESDAY, Sept. 2 (HealthDay News) -- In patients with moderate to severe chronic kidney disease who are undergoing coronary angiography, hydration with sodium bicarbonate is not superior to hydration with sodium chloride in preventing contrast medium-induced nephropathy, according to an article published in the Sept. 3 issue of the Journal of the American Medical Association.

Somjot S. Brar, M.D., of the Columbia University Medical Center in New York City, and colleagues randomly assigned 353 patients to receive either sodium bicarbonate or sodium chloride administered at a rate of 3 mL/kg for one hour before coronary angiography and at a rate of 1.5 mL/kg per hour during the procedure and for another four hours afterward.

The researchers found no significant group differences in the number of patients who achieved the primary end point: a 25 percent or greater decrease in the estimated glomerular filtration rate on days 1 through 4 (13.3 percent for the sodium bicarbonate group versus 14.6 percent for the sodium chloride group). They also found no significant group differences in the rates of death, dialysis, myocardial infarction, and cerebrovascular events at 30 days and at 30 days to six months.

"Any true difference between the hydration strategies is likely to be small and not clinically significant," the authors conclude.

This study was supported by Kaiser Permanente Southern California.

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