Trial reportInternational urology and nephrology2009
A comparison of sodium bicarbonate infusion versus normal saline infusion and its combination with oral acetazolamide for prevention of contrast-induced nephropathy: a randomized, double-blind trial.
Trial report in International urology and nephrology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 7 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 7 syntheses or guidelines pooled it, 67 citations in OpenAlex.
- Diuretics for preventing and treating acute kidney injury.The Cochrane database of systematic reviews · 2025Pooled it
- Hydration Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-Analysis.Journal of interventional cardiology · 2020Pooled it
- Effectiveness of contrast-associated acute kidney injury prevention methods; a systematic review and network meta-analysis.BMC nephrology · 2018Pooled it
- Pooled it
- Sodium bicarbonate versus isotonic saline solution to prevent contrast-induced nephropathy : a systematic review and meta-analysis.Colombia medica (Cali, Colombia) · 2015Pooled it
- Acute kidney injury.BMJ clinical evidence · 2011Pooled it
- Prevention of acute kidney injury and protection of renal function in the intensive care unit. Expert opinion of the Working Group for Nephrology, ESICM.Intensive care medicine · 2010Guideline
- Impact of heart failure on the incidence of contrast-induced nephropathy in patients with chronic kidney disease.International urology and nephrology · 2010Trial
- The role of acetazolamide in critical care and emergency medicine.Journal of geriatric cardiology : JGC · 2024Article
- Contrast-Induced Nephropathy: Update on the Use of Crystalloids and Pharmacological Measures.International journal of nephrology · 2018Review
- Update on the renal toxicity of iodinated contrast drugs used in clinical medicine.Drug, healthcare and patient safety · 2017Review
- Renal-related adverse effects of intravenous contrast media in computed tomography.Singapore medical journal · 2015Review
- Sodium bicarbonate infusion for prevention of acute kidney injury: no evidence for superior benefit, but risk for harm?International urology and nephrology · 2015Review
- Current status of sodium bicarbonate in coronary angiography: an updated comprehensive meta-analysis and systematic review.Cardiology research and practice · 2015Review
- Acute kidney injury by radiographic contrast media: pathogenesis and prevention.BioMed research international · 2014Review
- Side effects of radiographic contrast media: pathogenesis, risk factors, and prevention.BioMed research international · 2014Review
- Extended renal outcomes with use of iodixanol versus iohexol after coronary angiography.BioMed research international · 2014Observational
- Prevention of contrast-induced nephropathy through a knowledge of its pathogenesis and risk factors.TheScientificWorldJournal · 2014Review
- Contrast-induced nephropathy: pharmacology, pathophysiology and prevention.Insights into imaging · 2013Article
- Does bicarbonate prevent contrast-induced nephropathy in cardiovascular patients undergoing contrast imaging?Interactive cardiovascular and thoracic surgery · 2013Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundContrast-induced nephropathy (CIN) is commonly encountered. Because the therapy of choice for prevention of CIN is controversial, in this study we compared the preventive efficacy of bicarbonate (Bi) infusion in dextrose water versus normal saline (NLS) infusion alone or in combination with oral acetazolamide (AZ).
methodsIn a double-blind and randomized clinical trial, all patients undergoing coronary angiography or percutaneous coronary intervention received NLS (NLS group), its combination with AZ (AZ group) or infusion of Bi (Bi group) before the procedures. RIFLE (risk of renal failure, injury to the kidney, failure of kidney function, loss of kidney function, and end-stage renal disease) criteria were used to define CIN-associated acute kidney injury (AKI).
resultsThe risk of AKI in CIN was significantly lower in the Bi and AZ groups than in the NLS group (P <or= 0.04). Comparing pre-treatment and post-treatment values in each group the following results were obtained: serum creatinine (Scr) increased and eGFR decreased significantly in the NLS group (P = 0.04) and in all patients (P = 0.001, P = 0.02, respectively). In addition, serum potassium decreased significantly in the Bi and NLS groups (P <or= 0.02). Also, serum Bi increased significantly in the Bi group (P = 0.001) whereas it decreased significantly in the AZ group (P = 0.001). Urinary pH also increased in all groups (P <or= 0.04) except the NLS group (P > 0.05).
conclusionsIt seems that both Bi and AZ reduce the risk of CIN-related AKI, and close monitoring of serum potassium is needed during bicarbonate infusion.
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