Current role of sodium bicarbonate-based preprocedural hydration for the prevention of contrast-induced acute kidney injury: A meta-analysis

Shea E. Hogan, Phillipe L'Allier, Stanley Chetcuti, P. Michael Grossman, Brahmajee K. Nallamothu, Claire Duvernoy, Eric Bates, Mauro Moscucci, Hitinder S. Gurm

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Background: The optimal hydration strategy for prevention of contrast-induced acute kidney injury (AKI) remains unknown. The purpose of this meta-analysis is to compare the effectiveness of normal saline (NS) versus sodium bicarbonate hydration (NaHCO3) for prevention of contrast-induced AKI. Methods: We performed a meta-analysis of randomized controlled trials that compared saline-based hydration with sodium bicarbonate-based hydration regimen for prophylaxis of contrast-induced AKI. The literature search included MEDLINE, EMBASE, and Cochrane databases (2000 to October 2007); conference proceedings; and bibliographies of retrieved articles. Information was extracted on study design, sample characteristics, and interventions. Random-effects models were used to calculate summary risk ratios for contrast-induced AKI, need for hemodialysis, and death. Results: Seven trials with 1,307 subjects were included. Preprocedural hydration with sodium bicarbonate was associated with a significant decrease in the rate of contrast-induced AKI (5.96% in the NaHCO3 arm versus 17.23% in the NS arm, summary risk ratio 0.37, 95% CI 0.18-0.714, P = .005). There was no difference in the rates of postprocedure hemodialysis or death. Formal testing revealed moderate heterogeneity and a strong likelihood of publication bias. Conclusions: Although sodium bicarbonate hydration was found to be superior to NS in prevention of contrast-induced AKI, these results are in the context of study heterogeneity and, likely, publication bias. An adequately powered randomized controlled trial is warranted to define the optimal hydration strategy in patients at high risk of contrast-induced AKI who are scheduled to undergo contrast administration.

Original languageEnglish
Pages (from-to)414-421
Number of pages8
JournalAmerican Heart Journal
Volume156
Issue number3
DOIs
StatePublished - Sep 1 2008

Fingerprint

Sodium Bicarbonate
Acute Kidney Injury
Meta-Analysis
Publication Bias
Renal Dialysis
Randomized Controlled Trials
Odds Ratio
Bibliography
MEDLINE
Databases

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Hogan, S. E., L'Allier, P., Chetcuti, S., Grossman, P. M., Nallamothu, B. K., Duvernoy, C., ... Gurm, H. S. (2008). Current role of sodium bicarbonate-based preprocedural hydration for the prevention of contrast-induced acute kidney injury: A meta-analysis. American Heart Journal, 156(3), 414-421. https://doi.org/10.1016/j.ahj.2008.05.014

Current role of sodium bicarbonate-based preprocedural hydration for the prevention of contrast-induced acute kidney injury : A meta-analysis. / Hogan, Shea E.; L'Allier, Phillipe; Chetcuti, Stanley; Grossman, P. Michael; Nallamothu, Brahmajee K.; Duvernoy, Claire; Bates, Eric; Moscucci, Mauro; Gurm, Hitinder S.

In: American Heart Journal, Vol. 156, No. 3, 01.09.2008, p. 414-421.

Research output: Contribution to journalArticle

Hogan, SE, L'Allier, P, Chetcuti, S, Grossman, PM, Nallamothu, BK, Duvernoy, C, Bates, E, Moscucci, M & Gurm, HS 2008, 'Current role of sodium bicarbonate-based preprocedural hydration for the prevention of contrast-induced acute kidney injury: A meta-analysis', American Heart Journal, vol. 156, no. 3, pp. 414-421. https://doi.org/10.1016/j.ahj.2008.05.014
Hogan, Shea E. ; L'Allier, Phillipe ; Chetcuti, Stanley ; Grossman, P. Michael ; Nallamothu, Brahmajee K. ; Duvernoy, Claire ; Bates, Eric ; Moscucci, Mauro ; Gurm, Hitinder S. / Current role of sodium bicarbonate-based preprocedural hydration for the prevention of contrast-induced acute kidney injury : A meta-analysis. In: American Heart Journal. 2008 ; Vol. 156, No. 3. pp. 414-421.
@article{813ededd2bcb4d46bcaa0868e0e9fa38,
title = "Current role of sodium bicarbonate-based preprocedural hydration for the prevention of contrast-induced acute kidney injury: A meta-analysis",
abstract = "Background: The optimal hydration strategy for prevention of contrast-induced acute kidney injury (AKI) remains unknown. The purpose of this meta-analysis is to compare the effectiveness of normal saline (NS) versus sodium bicarbonate hydration (NaHCO3) for prevention of contrast-induced AKI. Methods: We performed a meta-analysis of randomized controlled trials that compared saline-based hydration with sodium bicarbonate-based hydration regimen for prophylaxis of contrast-induced AKI. The literature search included MEDLINE, EMBASE, and Cochrane databases (2000 to October 2007); conference proceedings; and bibliographies of retrieved articles. Information was extracted on study design, sample characteristics, and interventions. Random-effects models were used to calculate summary risk ratios for contrast-induced AKI, need for hemodialysis, and death. Results: Seven trials with 1,307 subjects were included. Preprocedural hydration with sodium bicarbonate was associated with a significant decrease in the rate of contrast-induced AKI (5.96{\%} in the NaHCO3 arm versus 17.23{\%} in the NS arm, summary risk ratio 0.37, 95{\%} CI 0.18-0.714, P = .005). There was no difference in the rates of postprocedure hemodialysis or death. Formal testing revealed moderate heterogeneity and a strong likelihood of publication bias. Conclusions: Although sodium bicarbonate hydration was found to be superior to NS in prevention of contrast-induced AKI, these results are in the context of study heterogeneity and, likely, publication bias. An adequately powered randomized controlled trial is warranted to define the optimal hydration strategy in patients at high risk of contrast-induced AKI who are scheduled to undergo contrast administration.",
author = "Hogan, {Shea E.} and Phillipe L'Allier and Stanley Chetcuti and Grossman, {P. Michael} and Nallamothu, {Brahmajee K.} and Claire Duvernoy and Eric Bates and Mauro Moscucci and Gurm, {Hitinder S.}",
year = "2008",
month = "9",
day = "1",
doi = "10.1016/j.ahj.2008.05.014",
language = "English",
volume = "156",
pages = "414--421",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",
number = "3",

}

TY - JOUR

T1 - Current role of sodium bicarbonate-based preprocedural hydration for the prevention of contrast-induced acute kidney injury

T2 - A meta-analysis

AU - Hogan, Shea E.

AU - L'Allier, Phillipe

AU - Chetcuti, Stanley

AU - Grossman, P. Michael

AU - Nallamothu, Brahmajee K.

AU - Duvernoy, Claire

AU - Bates, Eric

AU - Moscucci, Mauro

AU - Gurm, Hitinder S.

PY - 2008/9/1

Y1 - 2008/9/1

N2 - Background: The optimal hydration strategy for prevention of contrast-induced acute kidney injury (AKI) remains unknown. The purpose of this meta-analysis is to compare the effectiveness of normal saline (NS) versus sodium bicarbonate hydration (NaHCO3) for prevention of contrast-induced AKI. Methods: We performed a meta-analysis of randomized controlled trials that compared saline-based hydration with sodium bicarbonate-based hydration regimen for prophylaxis of contrast-induced AKI. The literature search included MEDLINE, EMBASE, and Cochrane databases (2000 to October 2007); conference proceedings; and bibliographies of retrieved articles. Information was extracted on study design, sample characteristics, and interventions. Random-effects models were used to calculate summary risk ratios for contrast-induced AKI, need for hemodialysis, and death. Results: Seven trials with 1,307 subjects were included. Preprocedural hydration with sodium bicarbonate was associated with a significant decrease in the rate of contrast-induced AKI (5.96% in the NaHCO3 arm versus 17.23% in the NS arm, summary risk ratio 0.37, 95% CI 0.18-0.714, P = .005). There was no difference in the rates of postprocedure hemodialysis or death. Formal testing revealed moderate heterogeneity and a strong likelihood of publication bias. Conclusions: Although sodium bicarbonate hydration was found to be superior to NS in prevention of contrast-induced AKI, these results are in the context of study heterogeneity and, likely, publication bias. An adequately powered randomized controlled trial is warranted to define the optimal hydration strategy in patients at high risk of contrast-induced AKI who are scheduled to undergo contrast administration.

AB - Background: The optimal hydration strategy for prevention of contrast-induced acute kidney injury (AKI) remains unknown. The purpose of this meta-analysis is to compare the effectiveness of normal saline (NS) versus sodium bicarbonate hydration (NaHCO3) for prevention of contrast-induced AKI. Methods: We performed a meta-analysis of randomized controlled trials that compared saline-based hydration with sodium bicarbonate-based hydration regimen for prophylaxis of contrast-induced AKI. The literature search included MEDLINE, EMBASE, and Cochrane databases (2000 to October 2007); conference proceedings; and bibliographies of retrieved articles. Information was extracted on study design, sample characteristics, and interventions. Random-effects models were used to calculate summary risk ratios for contrast-induced AKI, need for hemodialysis, and death. Results: Seven trials with 1,307 subjects were included. Preprocedural hydration with sodium bicarbonate was associated with a significant decrease in the rate of contrast-induced AKI (5.96% in the NaHCO3 arm versus 17.23% in the NS arm, summary risk ratio 0.37, 95% CI 0.18-0.714, P = .005). There was no difference in the rates of postprocedure hemodialysis or death. Formal testing revealed moderate heterogeneity and a strong likelihood of publication bias. Conclusions: Although sodium bicarbonate hydration was found to be superior to NS in prevention of contrast-induced AKI, these results are in the context of study heterogeneity and, likely, publication bias. An adequately powered randomized controlled trial is warranted to define the optimal hydration strategy in patients at high risk of contrast-induced AKI who are scheduled to undergo contrast administration.

UR - http://www.scopus.com/inward/record.url?scp=49949098247&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=49949098247&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2008.05.014

DO - 10.1016/j.ahj.2008.05.014

M3 - Article

C2 - 18760120

AN - SCOPUS:49949098247

VL - 156

SP - 414

EP - 421

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 3

ER -