Hydration with sodium bicarbonate does not prevent contrast nephropathy: a multicenter clinical trial

Arq Bras Cardiol. 2012 Dec;99(6):1129-34. doi: 10.1590/s0066-782x2012005000108. Epub 2012 Nov 27.
[Article in English, Portuguese]


Background: Radiographic contrast media exposition can cause acute renal function impairment. There is limited and conflicting evidence that hydration with sodium bicarbonate prevents contrast-induced nephropathy (CIN) in patients undergoing cardiac catheterization.

Objective: The present study was aimed at determining whether sodium bicarbonate is superior to hydration with saline to prevent nephropathy in patients at risk undergoing cardiac catheterization.

Methods: Three hundred and one patients undergoing coronary angiography or percutaneous coronary intervention with serum creatinine > 1.2mg/dL or glomerular filtration rate (GFR) < 50 ml/min were randomized to receive hydration with sodium bicarbonate starting 1 hour before the procedure and 6 hours after the procedure, or hydration with 0.9% saline. CIN was defined as an increase of 0.5mg/dL in creatinine in 48 h

Results: Eighteen patients (5.9%) developed contrast induced nephropathy: 9 patients in the bicarbonate group (6.1%) and 9 patients in the saline group (6.0%), p = 0.97. The change in serum creatinine was similar in both groups, 0.01 ± 0.26 mg/dL in the bicarbonate group and 0.01 ± 0.35 mg/dL in the saline group, p = 0.9. No statistical difference was observed between the change in glomerular filtration rate (0.89 ± 9 ml/min vs. 2.29 ± 10 ml/min, p = 0.2 bicarbonate group and saline group, respectively).

Conclusion: Hydration with sodium bicarbonate was not superior to saline to prevent contrast media induced nephropathy in patients at risk undergoing cardiac catheterization.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Cardiac Catheterization*
  • Contrast Media / adverse effects*
  • Creatinine / blood
  • Female
  • Fluid Therapy / methods*
  • Glomerular Filtration Rate / drug effects
  • Humans
  • Kidney Diseases / chemically induced*
  • Kidney Diseases / prevention & control*
  • Male
  • Middle Aged
  • Risk Factors
  • Sodium Bicarbonate / therapeutic use*
  • Sodium Chloride / therapeutic use
  • Statistics, Nonparametric
  • Time Factors
  • Treatment Outcome


  • Contrast Media
  • Sodium Chloride
  • Sodium Bicarbonate
  • Creatinine