Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study)
Autor(a) principal: | |
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Data de Publicação: | 2014 |
Outros Autores: | , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Jornal Brasileiro de Nefrologia |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002014000300360 |
Resumo: | Introduction: Contrast-induced nephropathy is a common complication of radiographic procedures. Different measures have been used to avoid this damage, but the evidence is controversial. New investigations are required to clarify it. We investigated the efficacy and safety of sodium bicarbonate solution compared with sodium chloride solution to prevent contrast induced nephropathy in patients with or at risk of renal dysfunction. Methods: A prospective, single-center, randomized clinical trial conducted from May 1, 2007 to February 8, 2008. Inpatients in a tertiary center, scheduled to undergo a procedure with the nonionic radiographic contrast agent iohexol. There were 220 patients with serum creatinine levels of at least 1.2 mg/dL (106.1 µmol/L) and/or type 2 diabetics, who were randomized to receive an infusion of sodium chloride (n = 113) or sodium bicarbonate (n = 107) before and after contrast dye administration. The intervention were "A" group received 1 ml/kg/hour of normal saline solution, starting 12 hours before and continuing 12 hours after iohexol contrast. "B" group received 3 ml/kg of sodium bicarbonate solution (150 mEq/L) one hour prior to procedure and then drip rate was decreased to 1 ml/kg/hour until 6 hours post procedure. Our main outcome measure was change in serum creatinine. Results: The mean creatinine value after the procedure was 1.26 mg/dL in the saline group and 1.22 mg/dL in the bicarbonate group (mean difference: 0.036; CI 95%: -0.16 to 0.23, p = 0.865). The diagnosis of contrast-induced nephropathy, defined by increase in serum creatinine on 25% or more within 2 days after administration of radiographic contrast, was done in twelve patients (12%) in the bicarbonate group and eighth patients (7.1%) in the saline group (RR: 1.68, CI 95%: 0.72 to 3.94). Conclusion: Our investigation showed that there were no differences between normal saline solution (extended infusion) vs. bicarbonate solution for nephroprotection. |
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Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study)acute kidney injurycontrast mediasaline waterssodium bicarbonate Introduction: Contrast-induced nephropathy is a common complication of radiographic procedures. Different measures have been used to avoid this damage, but the evidence is controversial. New investigations are required to clarify it. We investigated the efficacy and safety of sodium bicarbonate solution compared with sodium chloride solution to prevent contrast induced nephropathy in patients with or at risk of renal dysfunction. Methods: A prospective, single-center, randomized clinical trial conducted from May 1, 2007 to February 8, 2008. Inpatients in a tertiary center, scheduled to undergo a procedure with the nonionic radiographic contrast agent iohexol. There were 220 patients with serum creatinine levels of at least 1.2 mg/dL (106.1 µmol/L) and/or type 2 diabetics, who were randomized to receive an infusion of sodium chloride (n = 113) or sodium bicarbonate (n = 107) before and after contrast dye administration. The intervention were "A" group received 1 ml/kg/hour of normal saline solution, starting 12 hours before and continuing 12 hours after iohexol contrast. "B" group received 3 ml/kg of sodium bicarbonate solution (150 mEq/L) one hour prior to procedure and then drip rate was decreased to 1 ml/kg/hour until 6 hours post procedure. Our main outcome measure was change in serum creatinine. Results: The mean creatinine value after the procedure was 1.26 mg/dL in the saline group and 1.22 mg/dL in the bicarbonate group (mean difference: 0.036; CI 95%: -0.16 to 0.23, p = 0.865). The diagnosis of contrast-induced nephropathy, defined by increase in serum creatinine on 25% or more within 2 days after administration of radiographic contrast, was done in twelve patients (12%) in the bicarbonate group and eighth patients (7.1%) in the saline group (RR: 1.68, CI 95%: 0.72 to 3.94). Conclusion: Our investigation showed that there were no differences between normal saline solution (extended infusion) vs. bicarbonate solution for nephroprotection. Sociedade Brasileira de Nefrologia2014-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002014000300360Brazilian Journal of Nephrology v.36 n.3 2014reponame:Jornal Brasileiro de Nefrologiainstname:Sociedade Brasileira de Nefrologia (SBN)instacron:SBN10.5935/0101-2800.20140051info:eu-repo/semantics/openAccessNieto-Ríos,John FredySalazar,Wílmar Arley MayaSánchez,Oscar Mauricio SantosOrtega,Janeth Liliana JaramilloCaro,Jorge Ignacio GarcíaAristizabal,Julián Miguel AristizabalHiguita,Lina Maria SernaGarcía,Álvaro GarcíaBarragán,Fabián Alberto Jaimeseng2014-10-09T00:00:00Zoai:scielo:S0101-28002014000300360Revistahttp://www.bjn.org.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||jbn@sbn.org.br2175-82390101-2800opendoar:2014-10-09T00:00Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN)false |
dc.title.none.fl_str_mv |
Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study) |
title |
Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study) |
spellingShingle |
Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study) Nieto-Ríos,John Fredy acute kidney injury contrast media saline waters sodium bicarbonate |
title_short |
Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study) |
title_full |
Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study) |
title_fullStr |
Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study) |
title_full_unstemmed |
Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study) |
title_sort |
Prevention of contrast induced nephropathy with sodium bicarbonate (the PROMEC study) |
author |
Nieto-Ríos,John Fredy |
author_facet |
Nieto-Ríos,John Fredy Salazar,Wílmar Arley Maya Sánchez,Oscar Mauricio Santos Ortega,Janeth Liliana Jaramillo Caro,Jorge Ignacio García Aristizabal,Julián Miguel Aristizabal Higuita,Lina Maria Serna García,Álvaro García Barragán,Fabián Alberto Jaimes |
author_role |
author |
author2 |
Salazar,Wílmar Arley Maya Sánchez,Oscar Mauricio Santos Ortega,Janeth Liliana Jaramillo Caro,Jorge Ignacio García Aristizabal,Julián Miguel Aristizabal Higuita,Lina Maria Serna García,Álvaro García Barragán,Fabián Alberto Jaimes |
author2_role |
author author author author author author author author |
dc.contributor.author.fl_str_mv |
Nieto-Ríos,John Fredy Salazar,Wílmar Arley Maya Sánchez,Oscar Mauricio Santos Ortega,Janeth Liliana Jaramillo Caro,Jorge Ignacio García Aristizabal,Julián Miguel Aristizabal Higuita,Lina Maria Serna García,Álvaro García Barragán,Fabián Alberto Jaimes |
dc.subject.por.fl_str_mv |
acute kidney injury contrast media saline waters sodium bicarbonate |
topic |
acute kidney injury contrast media saline waters sodium bicarbonate |
description |
Introduction: Contrast-induced nephropathy is a common complication of radiographic procedures. Different measures have been used to avoid this damage, but the evidence is controversial. New investigations are required to clarify it. We investigated the efficacy and safety of sodium bicarbonate solution compared with sodium chloride solution to prevent contrast induced nephropathy in patients with or at risk of renal dysfunction. Methods: A prospective, single-center, randomized clinical trial conducted from May 1, 2007 to February 8, 2008. Inpatients in a tertiary center, scheduled to undergo a procedure with the nonionic radiographic contrast agent iohexol. There were 220 patients with serum creatinine levels of at least 1.2 mg/dL (106.1 µmol/L) and/or type 2 diabetics, who were randomized to receive an infusion of sodium chloride (n = 113) or sodium bicarbonate (n = 107) before and after contrast dye administration. The intervention were "A" group received 1 ml/kg/hour of normal saline solution, starting 12 hours before and continuing 12 hours after iohexol contrast. "B" group received 3 ml/kg of sodium bicarbonate solution (150 mEq/L) one hour prior to procedure and then drip rate was decreased to 1 ml/kg/hour until 6 hours post procedure. Our main outcome measure was change in serum creatinine. Results: The mean creatinine value after the procedure was 1.26 mg/dL in the saline group and 1.22 mg/dL in the bicarbonate group (mean difference: 0.036; CI 95%: -0.16 to 0.23, p = 0.865). The diagnosis of contrast-induced nephropathy, defined by increase in serum creatinine on 25% or more within 2 days after administration of radiographic contrast, was done in twelve patients (12%) in the bicarbonate group and eighth patients (7.1%) in the saline group (RR: 1.68, CI 95%: 0.72 to 3.94). Conclusion: Our investigation showed that there were no differences between normal saline solution (extended infusion) vs. bicarbonate solution for nephroprotection. |
publishDate |
2014 |
dc.date.none.fl_str_mv |
2014-09-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002014000300360 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0101-28002014000300360 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.5935/0101-2800.20140051 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
publisher.none.fl_str_mv |
Sociedade Brasileira de Nefrologia |
dc.source.none.fl_str_mv |
Brazilian Journal of Nephrology v.36 n.3 2014 reponame:Jornal Brasileiro de Nefrologia instname:Sociedade Brasileira de Nefrologia (SBN) instacron:SBN |
instname_str |
Sociedade Brasileira de Nefrologia (SBN) |
instacron_str |
SBN |
institution |
SBN |
reponame_str |
Jornal Brasileiro de Nefrologia |
collection |
Jornal Brasileiro de Nefrologia |
repository.name.fl_str_mv |
Jornal Brasileiro de Nefrologia - Sociedade Brasileira de Nefrologia (SBN) |
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||jbn@sbn.org.br |
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1752122063438479360 |