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Current status of sodium bicarbonate in coronary angiography: an updated comprehensive meta-analysis and systematic review.

Ali-Hassan-Sayegh S, Mirhosseini SJ, Rahimizadeh E, Ghodratipour Z, Sarrafan-Chaharsoughi Z, Dehghan AM, Lotfaliani MR, Rezaeisadrabadi M, Kayvanpour E, Sedaghat-Hamedani F, Zeriouh M, Weymann A, Sabashnikov A, Popov AF - Cardiol Res Pract (2015)

Bottom Line: This systematic review with meta-analysis sought to determine comparison of efficacy and safety of hydration with sodium bicarbonate versus sodium chloride on contrast induced nephropathy and clinical outcomes.Overall, hydration with sodium bicarbonate could significantly reduce CIN and the length of hospital stay compared to sodium chloride.In addition NAC added as a supplement to sodium bicarbonate could increase prophylactic effects against nephropathy.

View Article: PubMed Central - PubMed

Affiliation: Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

ABSTRACT
This systematic review with meta-analysis sought to determine comparison of efficacy and safety of hydration with sodium bicarbonate versus sodium chloride on contrast induced nephropathy and clinical outcomes. We searched major electronic databases for studies in randomized controlled trials. A value of P < 0.1 for Q test or I (2) > 50% indicated significant heterogeneity between the studies. Literature search of all databases retrieved 650 studies. 29 studies enrolled in meta-analysis. Pooled analysis indicated about the incidence of CIN (OR of 0.718; 95% CI: 0.60 to 0.85; P = 0.000), requirement of hemodialysis (OR of 1.00; 95% CI: 0.49 to 2.01; P = 0.9), mean changes of serum creatinine (WMD of 2.321; 95% CI: 1.995 to 2.648; P = 0.000), length of hospital stays (WMD of -0.774; 95% CI: -1.65 to 0.10; P = 0.08), major adverse cardiovascular events (OR = 1.075, 95% CI: 0.59 to 1.95; P = 0.8), and mortality (OR of 0.73; 95% CI: 0.42 to 1.26; P = 0.2). Overall, hydration with sodium bicarbonate could significantly reduce CIN and the length of hospital stay compared to sodium chloride. In addition NAC added as a supplement to sodium bicarbonate could increase prophylactic effects against nephropathy.

No MeSH data available.


Related in: MedlinePlus

Forest plot of odds ratio (OR) for treatment with N-acetyl cysteine and hydration with sodium bicarbonate on contrast-induced nephropathy.
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fig4: Forest plot of odds ratio (OR) for treatment with N-acetyl cysteine and hydration with sodium bicarbonate on contrast-induced nephropathy.

Mentions: A total of 5 RCTs (854 patients) were used for the analysis. Patient population of the RCTs ranged from 42 to 358 patients. From 854 patients, 433 cases were allocated to SB alone and 421 to the SB plus NAC group. The overall incidence of CIN was 12.67% ranging from 5.17% to 21.17%. CIN occurred in 14.08% in SB alone and 11.16% in SB plus NAC group. Pooled treatment effect analysis revealed that SB plus NAC versus SB alone had trend towards reducing the incidence of CIN with an OR of 1.32 (95% CI: 0.87–1.99; P = 0.1) using a random model. Significant heterogeneity was observed among the RCTs (chi-squared = 8.42, I2 = 52.5%) (Figure 4).


Current status of sodium bicarbonate in coronary angiography: an updated comprehensive meta-analysis and systematic review.

Ali-Hassan-Sayegh S, Mirhosseini SJ, Rahimizadeh E, Ghodratipour Z, Sarrafan-Chaharsoughi Z, Dehghan AM, Lotfaliani MR, Rezaeisadrabadi M, Kayvanpour E, Sedaghat-Hamedani F, Zeriouh M, Weymann A, Sabashnikov A, Popov AF - Cardiol Res Pract (2015)

Forest plot of odds ratio (OR) for treatment with N-acetyl cysteine and hydration with sodium bicarbonate on contrast-induced nephropathy.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4417980&req=5

fig4: Forest plot of odds ratio (OR) for treatment with N-acetyl cysteine and hydration with sodium bicarbonate on contrast-induced nephropathy.
Mentions: A total of 5 RCTs (854 patients) were used for the analysis. Patient population of the RCTs ranged from 42 to 358 patients. From 854 patients, 433 cases were allocated to SB alone and 421 to the SB plus NAC group. The overall incidence of CIN was 12.67% ranging from 5.17% to 21.17%. CIN occurred in 14.08% in SB alone and 11.16% in SB plus NAC group. Pooled treatment effect analysis revealed that SB plus NAC versus SB alone had trend towards reducing the incidence of CIN with an OR of 1.32 (95% CI: 0.87–1.99; P = 0.1) using a random model. Significant heterogeneity was observed among the RCTs (chi-squared = 8.42, I2 = 52.5%) (Figure 4).

Bottom Line: This systematic review with meta-analysis sought to determine comparison of efficacy and safety of hydration with sodium bicarbonate versus sodium chloride on contrast induced nephropathy and clinical outcomes.Overall, hydration with sodium bicarbonate could significantly reduce CIN and the length of hospital stay compared to sodium chloride.In addition NAC added as a supplement to sodium bicarbonate could increase prophylactic effects against nephropathy.

View Article: PubMed Central - PubMed

Affiliation: Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

ABSTRACT
This systematic review with meta-analysis sought to determine comparison of efficacy and safety of hydration with sodium bicarbonate versus sodium chloride on contrast induced nephropathy and clinical outcomes. We searched major electronic databases for studies in randomized controlled trials. A value of P < 0.1 for Q test or I (2) > 50% indicated significant heterogeneity between the studies. Literature search of all databases retrieved 650 studies. 29 studies enrolled in meta-analysis. Pooled analysis indicated about the incidence of CIN (OR of 0.718; 95% CI: 0.60 to 0.85; P = 0.000), requirement of hemodialysis (OR of 1.00; 95% CI: 0.49 to 2.01; P = 0.9), mean changes of serum creatinine (WMD of 2.321; 95% CI: 1.995 to 2.648; P = 0.000), length of hospital stays (WMD of -0.774; 95% CI: -1.65 to 0.10; P = 0.08), major adverse cardiovascular events (OR = 1.075, 95% CI: 0.59 to 1.95; P = 0.8), and mortality (OR of 0.73; 95% CI: 0.42 to 1.26; P = 0.2). Overall, hydration with sodium bicarbonate could significantly reduce CIN and the length of hospital stay compared to sodium chloride. In addition NAC added as a supplement to sodium bicarbonate could increase prophylactic effects against nephropathy.

No MeSH data available.


Related in: MedlinePlus