BACKGROUND: Contrast-induced nephropathy (CIN) is associated with worse clinical outcomes both at short and long-term follow-up. Recent evidence indicates that intravenous hydration with sodium-bicarbonate may reduce the incidence of CIN. However, this strategy has not been reported in diabetic patients. METHODS: Sub-analysis of a multicenter study involving 301 patients with serum creatinine > 1,2 mg/dL or creatinine clearance < 50 mL/min submitted to coronary angiography or percutaneous coronary intervention and randomized to intravenous hydration with sodium-bicarbonate or normal saline. All patients received low-osmolar contrast media. We assessed the incidence of CIN (defined as creatinine increase > 0,5 mg/dL), and the average change in creatinine and creatinine clearance 48 hours after the procedure. A total of 87 diabetic patients were analyzed. RESULTS: There was no difference between groups regarding baseline characteristics, contrast volume used, baseline creatinine levels and creatinine clearance. Eight patients presented CIN: 4 (9.8%) in the bicarbonate group and 4 (8.9%) in the saline group (p = 0.9). The average change in serum creatinine and creatinine clearance were similar between groups. CONCLUSION: Intravenous hydration with sodium-bicarbonate did not reduce the incidence of CIN in diabetic patients undergoing coronary angiography or percutaneous coronary intervention as compared to hydration with normal saline.
Contrast media; Kidney diseases; Renal insufficiency; Sodium bicarbonate
