Sodium Bicarbonate May Increase CN Risk
Large study also reveals that N-acetylcysteine offers no renal protection.
Sodium bicarbonate may increase the risk of contrast nephropathy (CN), recent findings suggest.
Researchers at the Mayo Clinic in
Compared with patients who received no prophylaxis against CN, those treated with sodium bicarbonate alone had a three times higher risk of CN. An increased risk of CN persisted even when patients were stratified by glomerular filtration rate (GFR). The risk of CN associated with sodium bicarbonate alone was 3.62 times higher among patients with a GFR of 60 mL/min or more and 2.64 times higher in patients with a GFR below 60 mL/min. The risk was not significantly affected by NAC alone or combined with sodium bicarbonate.
“The clinical use of sodium bicarbonate for renal protection should be reconsidered until further investigation can elucidate its proper use,” the authors concluded.
In a separate study of 57 patients with CKD stages 2 to 4 undergoing coronary angiography or angioplasty,
Additionally, a group at
The study, which examined 513 cardiac catheterizations, demonstrated no significant difference in CN incidence even among a small subset of patients with a pre-procedure glomerular filtration rate less than 60 mL/min, the defining limit for stage 3 CKD.