Alonso P, et al. – A potential prophylactic benefit of peri–procedural intravenous volume expansion with isotonic saline and sodium bicarbonate solution against the development of contrast–induced nephropathy (CIN) in patients undergoing CRT implantation, was investigated in this current research. Findings revealed that in a non–selected population of patients receiving a CRT–device, the reported CIN incidence was 11%. Notably, outcomes indicated that CIN development could be attenuated by using a hydration protocol based on sodium bicarbonate and isotonic saline.

Methods

• In this current study, researchers randomly assigned eligible patients in a 1:1 ratio to receive hydration plus one sixth molar sodium bicarbonate (study group) or not (control group).
• Primary end-point was CIN incidence.
• Secondary end-points were: (i) a combined end point of death, heart transplantation or hospitalization for heart failure at 12 months, (ii) incidence of death, and (iii) the need of renal replacement therapy at 12 months.
• They performed final analysis with 93 patients.

Results

• Findings demonstrated that in the hydration group, CIN incidence was significantly reduced related to control group (0% vs 11%, p=0.02).
• Researchers observed that there was a trend to reduce the combined end-point in hydration group (12.5% vs 22%, p=0.14).
• They also noted that CIN incidence was related to a higher 12 months mortality (25% vs 7%, p=0.03).