In this meta-analysis of 12 trials with over 1800 participants, HCo3 reduced the risk of contrast induced nephropathy (CIN) compared to controls (OR 0.46, CI 0.26-0.82) and compared to normal saline (OR 0.39, CI 0.2-0.8), but not compared to N-acetylcysteine / normal saline combination. It also did not reduce the need for renal replacement therapy, in hospital death, or CHF in any of the subgroups. Although Hco3 can reduce the incidence of CIN (compared to controls or saline), it’s clinical significance is still unclear (abstract).
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.