Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • News & Views
  • Published:

Acute kidney injury

Prevention of contrast-induced AKI—the ongoing saga

Nature Reviews Nephrology volume 8, pages 260–261 (2012)Cite this article

Subjects

Comparisons of sodium chloride and sodium bicarbonate for the prevention of contrast-induced acute kidney injury have produced inconclusive results. A new study by Klima et al. shows that sodium chloride provides greater renal protection than does sodium bicarbonate following exposure to contrast medium. However, this finding should be interpreted with caution.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1: Incidence of contrast-induced AKI in small and large trials comparing sodium bicarbonate and sodium chloride hydration regimens.10

References

  1. McCullough, P. A., Wolyn, R., Rocher, L. L., Levin, R. N. & O'Neill, W. W. Acute renal failure after coronary intervention: incidence, risk factors, and relationship to mortality. Am. J. Med. 103, 368–375 (1997).

    Article  CAS  Google Scholar 

  2. Rihal, C. S. et al. Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. Circulation 105, 2259–2264 (2002).

    Article  Google Scholar 

  3. Russo, D. et al. Early effects of contrast media on renal hemodynamics and tubular function in chronic renal failure. J. Am. Soc. Nephrol. 6, 1451–1458 (1995).

    CAS  PubMed  Google Scholar 

  4. Brar, S. S. et al. Sodium bicarbonate vs sodium chloride for the prevention of contrast medium-induced nephropathy in patients undergoing coronary angiography: a randomized trial. JAMA 300, 1038–1046 (2008).

    Article  CAS  Google Scholar 

  5. Maioli, M. et al. Sodium bicarbonate versus saline for the prevention of contrast-induced nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention. J. Am. Coll. Cardiol. 52, 599–604 (2008).

    Article  CAS  Google Scholar 

  6. Klima, T. et al. Sodium chloride vs. sodium bicarbonate for the prevention of contrast medium-induced nephropathy: a randomized controlled trial. Eur. Heart J. http://dx.doi.org/10.1093/eurheartj/ehr501.

  7. Mehran, R. et al. A simple risk score for prediction of contrast-induced nephropathy after percutaneous coronary intervention: development and initial validation. J. Am. Coll. Cardiol. 44, 1393–1399 (2004).

    PubMed  Google Scholar 

  8. Masuda, M. et al. Comparison of usefulness of sodium bicarbonate versus sodium chloride to prevent contrast-induced nephropathy in patients undergoing an emergent coronary procedure. Am. J. Cardiol. 100, 781–786 (2007).

    Article  CAS  Google Scholar 

  9. Merten, G. J. et al. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA 291, 2328–2334 (2004).

    Article  CAS  Google Scholar 

  10. Brar, S. S. et al. Sodium bicarbonate for the prevention of contrast induced-acute kidney injury: a systematic review and meta-analysis. Clin. J. Am. Soc. Nephrol. 4, 1584–1592 (2009).

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Zena and Michael A. Wiener Cardiovascular Institute, Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, 10029-6574, NY, USA

    Usman Baber & Roxana Mehran

Authors
  1. Usman Baber
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roxana Mehran
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Roxana Mehran.

Ethics declarations

Competing interests

R. Mehran is a consultant for AstraZeneca, has received grant/research support from Bristol-Myers Squibb/Sanofi-Aventis and The Medicines Company, and is on the advisory board of Johnson & Johnson and Regado Biosciences. U. Baber declares no competing interests.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baber, U., Mehran, R. Prevention of contrast-induced AKI—the ongoing saga. Nat Rev Nephrol 8, 260–261 (2012). https://doi.org/10.1038/nrneph.2012.57

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/nrneph.2012.57

This article is cited by

Search

Advanced search

Quick links

Nature Briefing: Translational Research

Sign up for the Nature Briefing: Translational Research newsletter — top stories in biotechnology, drug discovery and pharma.

Get what matters in translational research, free to your inbox weekly. Sign up for Nature Briefing: Translational Research