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 language | English |
|---|---|
| Pages (from-to) | 414-421 |
| Number of pages | 8 |
| Journal | American Heart Journal |
| Volume | 156 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 1 2008 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
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 journal › Article
}
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 -