Use of isotonic sodium bicarbonate to prevent radiocontrast nephropathy in patients with mild pre-existing renal impairment: a meta-analysis.

作者: K. M. Ho , D. J. Morgan

DOI: 10.1177/0310057X0803600503

关键词:

摘要: Acute renal dysfunction after radiocontrast in patients with pre-existing impairment is not uncommon and associated significant morbidity mortality. Isotonic sodium bicarbonate solution was first reported to reduce nephropathy 2004. This study was, however, limited by its small sample size as such, the use of isotonic prevent still widely used many anaesthetists intensivists. We meta-analysed relevant randomised controlled studies sourced from Cochrane Controlled Trial Register (2007 issue 4), EMBASE MEDLINE databases (1966 April 15, 2008) without any language restriction. The a reduction risk an incremental rise serum creatinine concentration 25% above baseline (relative 0.22, 95% confidence interval [CI]: 0.11 0.44, P <0.0001; I2=0%) had protective effect on absolute change (weighted-mean-difference -9.4 µmol/l, CI: -17.2 -1.7, P=0.02; clearance 3.7 ml/min, 0.55 6.80, I2=57.1%) radiocontrast. incidence acute failure requiring dialysis low (1.4%) significantly different 0.59, 0.15 2.42, P=0.47; I2=0%). With data available, appears be safe very effective reducing mild impairment. A large needed confirm whether can improve patient centred clinical outcomes.

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