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).
Synthetic marijuana, or “spice” has been linked to at least 16 cases of acute renal failure, according to the CDC. Unexplained renal failure in young otherwise healthy patients should prompt questioning about synthetic marijuana use (CDC site).
In this case-control study, patients on ACE/ARBs were significantly more likely than those not on ACE/ARBs to experience contrast-induced acute kidney injury (odds ratio 1.4, CI 1.1 to 1.8). However, this does not prove causality, and it is not clear that discontinuing ACE/ARBs before a contrast load would prevent the kidney injury (abstract).
In this large administrative database analysis of patients with non-valvular afib, patients with ESRD were significantly more likely to suffer stroke, system thromboembolism, and bleeding than those without ESRD; the risk of stroke/embolism was significantly lower for those on warfarin but not those on ASA, while the risk of bleeding was higher with both ASA […]