Sodium Bicarbonate May Prevent Post-Op Acute Kidney Injury

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HOUSTON—Sodium bicarbonate loading and continuous infusion may protect cardiac surgery patients from acute kidney injury (AKI).

The finding comes from a double-blind, randomized pilot study of 100 patients undergoing cardiac surgery and who were at high risk of postoperative AKI. Anja Haase-Fielitz, PharmaD, of Charité University Medicine, Berlin, and colleagues randomly assigned 50 subjects to receive 24 hours of IV infusion of sodium bicarbonate (4 mmol/kg) and 50 to receive sodium chloride (4 mmol/kg).

The primary outcome was the proportion of patients who experienced acute renal dysfunction, defined as a greater than 25% postoperative increase in plasma creatinine level within the first five days after surgery.

Significantly fewer patients in the sodium bicarbonate group experienced postoperative acute renal dysfunction compared with the sodium chloride group (16 vs. 26), which translated into a 57% reduced risk, according to researchers. Dr. Haase-Fielitz reported study findings here at the 29th Annual Dialysis Conference.

The findings also were published recently in Critical Care Medicine (2009;37:39-47).

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