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Prevention of Radiocontrast Nephropathy
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Glenn M. Chertow, MD, MPH
JAMA. 2004;291:2376-2377.
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In this issue of THE JOURNAL, the study by Merten and colleagues1 provides important data on radiocontrast nephropathy, an ongoing focus of research in acute kidney disease. In 119 patients with a baseline serum creatinine concentration of at least 1.1 mg/dL, the authors compared 0.9% sodium chloride with an isotonic solution of sodium bicarbonate, administered at rates of 3 mL/kg per hour for 1 hour before and 1 mL/kg per hour for 6 hours after radiocontrast exposure. Radiocontrast nephropathy, defined as an increase of 25% or more in serum creatinine, developed in less than 2% of patients receiving sodium bicarbonate compared with 14% in the group receiving saline. The 2% rate in the intervention group was confirmed in an open-label follow-up registry. The authors postulated that the effects of bicarbonate on urine pH might reduce oxygen free-radical formation, thereby reducing radiocontrast-induced injury.
Radiocontrast nephropathy is . . . [Full Text of this Article]
Author Affiliations: Division of Nephrology, Departments of Medicine, Epidemiology, and Biostatistics, University of California, San Francisco.
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