NaCl better than Hco3 for reducing contrast nephropathy, but duration matters

In this randomized trial of patients with renal insufficiency undergoing procedures with IV contrast, they were randomized to normal saline (1cc/kg/hr for 12 hours before and after procedure), or Hco3 (2 different regimens; 3cc/kg an hour before and 1cc/kg/hr for 6 hours after, or 3cc/kg 20 minutes before and oral Hco3 after at 500mg/10kg). The saline group was significantly less likely than either Hco3 group to develop contrast induced nephropathy (1% vs 9% in both Hc03 groups) and had less change in gfr (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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