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Abstract
Contrast-induced nephropathy is a potentially avoidable complication caused during procedures involving the use of radiographic contrast media. All subjects, especially the high-risk ones should be subjected to available preventive protocols prior to and after such procedures.
The current study was done to evaluate the efficacy of a hydration protocol involving the use of sodium bicarbonate instead of the conventional sodium chloride hydration protocol.
The current study was conducted on 150 patients presenting to the Cardiology department at Ain Shams University Hospitals to undergo coronary angiography for different indications in the period between December 2005 and July 2006.
All patients were subjected to proper history taking, thorough clinical examination, standard twelve-lead surface ECG and coronary angiography. Three venous samples were withdrawn from all patients before the procedure, the morning after the procedure and forty-eight hours after it.
The study population was divided into two groups, the first received sodium bicarbonate hydration while the second received sodium chloride hydration prior to and after the procedure.
The current study found no significant differences between both hydration protocols regarding the development of contrast-induced nephropathy among the study population as a whole and also among those with pre-existing renal impairment, diabetes mellitus and those older than 60 years of age.
It was, however, concluded that for patients with pre-existing renal impairment, sodium bicarbonate hydration reduces the change in serum creatinine level as well as the change in creatinine clearance occurring forty-eight hours after contrast medium administration compared to sodium chloride hydration.
It was also concluded from the current study that hydration is a safe, cheap and effective method that should be applied to all patients undergoing any procedure involving the use of intravenous contrast media