HCO3 bolus to prevent contrast nephropathy

In this randomized trial of 144 patients with mild renal insufficiency (creatinine 1.1-2.0) undergoing elective cardiac catheterization, they were randomized to a single 20meq HCO3 bolus before contrast, and all received hydration. The incidence of nephropathy within 3 days (25% or 0.5 increase from baseline creatinine) was significantly lower in the HCO3 group (1% vs 13%). A single HCO3 bolus before contrast (added to hydration) appears to be effective in reducing post-procedure nephropathy in patients with mild renal insufficiency (abstract).

Danielle Scheurer

Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.

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