Prevention of Contrast Induced Nephropathy With Sodium Bicarbonate
Status:
Unknown status
Trial end date:
1969-12-31
Target enrollment:
Participant gender:
Summary
This will be a randomized controlled trial closely following the original protocol in the
previous study published in JAMA 2004 by Merten et al. Patients will be randomly assigned to
one of two treatment groups. Treatment group A will receive 1cc/kg/hour of 0.9% normal saline
at least 2 hours prior to study beginning and will be continued during and for 6 hours post
contrast. Treatment group B will receive 3cc/kg of sodium bicarbonate solution for one hour
prior to procedure then drip rate will be decreased to 1cc/kg/hour during and for 6 hours
post procedure. The sodium bicarbonate solution will be made by adding 3 amps of bicarbonate
to 1L of D5W. Patients in both treatment arms weighing >110kg the initial fluid bolus and
drip will be limited to those patients weighing 110kg. In both treatment arms, diuretics will
be held before and after contrast administration on the day of the study. BMP will be checked
the day of, 24 and 48 hours post contrast administration. The greatest change in all readings
will be used for treatment comparisons. Contrast induced nephropathy will be defined as a
change in serum creatinine of more than 25% from baseline and/or 0.5mg/dL. Urinary pH will
also be measured on first spontaneous void following bolus. Vital signs including blood
pressure and oxygen saturation will be documented every 4 hours to monitor patients closely
for signs and symptoms of volume overload