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PREVENTION OF CONTRAST-INDUCED NEPHROPATHY WITH BOLUS INJECTION OF SODIUM BICARBONATE IN PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING AN EMERGENT CORONARY PROCEDURE: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL
A102.E958 JACC March 9, 2010 Volume 55, issue 10A
MYOCARDIAL ISCHEMIA AND INFARCTION PREVENTION OF CONTRAST-INDUCED NEPHROPATHY WITH BOLUS INJECTION OF SODIUM BICARBONATE IN PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING AN EMERGENT CORONARY PROCEDURE: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL ACC Poster Contributions Georgia World Congress Center, Hall B5 Sunday, March 14, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Acute Myocardial Infarction--Optimizing Therapy in High Risk Subsets: Renal Failure Abstract Category: Acute Myocardial Infarction--Therapy Presentation Number: 1046-286 Authors: Hiromichi Ueda, Takahisa Yamada, Yuji Okuyama, Takashi Morita, Yoshio Furukawa, Koji Tanaka, Yusuke Iwasaki, Taku yasui, Takeshi Okada, Masato Kawasaki, Yuki Kuramoto, Masatake Fukunami, Osaka General Medical Center, Osaka, Japan Background: Previous studies have shown that sodium chloride (SC) or sodium bicarbonate (SB) administration before contrast media injection reduces the risk of contrast-induced nephropathy. However, we couldn’t have any time to administrate sufficient fluid injection in an emergent case with chronic kidney disease (CKD) such as acute coronary syndrome. There is no information available on the effect of the bolus injection with SB in an emergent case with CKD. Methods: We enrolled 38 patients with CKD (serum creatinine>1.1mg/dl or estimated glomerular filtration rate (eGFR) by the MDRD equation<60ml/min/1.73m2), who underwent an emergent coronary angiography or intervention. They were randomized to receive an infusion of either SC (n=20) or SB (n=18), as a bolus of 0.5ml/kg just before the administration of contrast media injection, followed by an infusion of 1 ml/ kg/h sodium bicarbonate for 6 hours during and after the procedure. Serum creatinine level was measured at baseline and 2 days after the contrast media administration. Results: There were no significant differences in age, sex, incidence of diabetes mellitus, contrast volume, left ventricular ejection fraction and the baseline serum creatinine level between the two groups. Serum creatinine level remained unchanged in SB group (1.21±0.26 to 1.07±0.28mg/dl, P=0.18), although it significantly increased (1.49±0.67 to 1.76±1.35mg/dl, P<0.05) 2 days after the contrast media administration in SC group. Conclusion: In patients with chronic kidney disease undergoing an emergent coronary procedure, bolus injection with SB would preserve shortterm renal function.
MYOCARDIAL ISCHEMIA AND INFARCTION PREVENTION OF CONTRAST-INDUCED NEPHROPATHY WITH BOLUS INJECTION OF SODIUM BICARBONATE IN PATIENTS WITH CHRONIC KIDNEY DISEASE UNDERGOING AN EMERGENT CORONARY PROCEDURE: A PROSPECTIVE RANDOMIZED CONTROLLED TRIAL ACC Poster Contributions Georgia World Congress Center, Hall B5 Sunday, March 14, 2010, 9:30 a.m.-10:30 a.m.
Session Title: Acute Myocardial Infarction--Optimizing Therapy in High Risk Subsets: Renal Failure Abstract Category: Acute Myocardial Infarction--Therapy Presentation Number: 1046-286 Authors: Hiromichi Ueda, Takahisa Yamada, Yuji Okuyama, Takashi Morita, Yoshio Furukawa, Koji Tanaka, Yusuke Iwasaki, Taku yasui, Takeshi Okada, Masato Kawasaki, Yuki Kuramoto, Masatake Fukunami, Osaka General Medical Center, Osaka, Japan Background: Previous studies have shown that sodium chloride (SC) or sodium bicarbonate (SB) administration before contrast media injection reduces the risk of contrast-induced nephropathy. However, we couldn’t have any time to administrate sufficient fluid injection in an emergent case with chronic kidney disease (CKD) such as acute coronary syndrome. There is no information available on the effect of the bolus injection with SB in an emergent case with CKD. Methods: We enrolled 38 patients with CKD (serum creatinine>1.1mg/dl or estimated glomerular filtration rate (eGFR) by the MDRD equation<60ml/min/1.73m2), who underwent an emergent coronary angiography or intervention. They were randomized to receive an infusion of either SC (n=20) or SB (n=18), as a bolus of 0.5ml/kg just before the administration of contrast media injection, followed by an infusion of 1 ml/ kg/h sodium bicarbonate for 6 hours during and after the procedure. Serum creatinine level was measured at baseline and 2 days after the contrast media administration. Results: There were no significant differences in age, sex, incidence of diabetes mellitus, contrast volume, left ventricular ejection fraction and the baseline serum creatinine level between the two groups. Serum creatinine level remained unchanged in SB group (1.21±0.26 to 1.07±0.28mg/dl, P=0.18), although it significantly increased (1.49±0.67 to 1.76±1.35mg/dl, P<0.05) 2 days after the contrast media administration in SC group. Conclusion: In patients with chronic kidney disease undergoing an emergent coronary procedure, bolus injection with SB would preserve shortterm renal function.