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Eur Heart J. 2013 Aug;34(30):2362-7. doi: 10.1093/eurheartj/eht009. Epub 2013 Jan 24.

Prevention of contrast-induced nephropathy with Na/K citrate.

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1
Department of Cardiology, University Clinical Hospital Mostar, Mostar, Bosnia and Herzegovina.

Abstract

AIMS:

Contrast-induced nephropathy (CIN) is a frequent complication of many radiological procedures involving the application of contrast media. It represents a significant health problem that causes the increase in mortality, morbidity, and medical costs. For the prevention of CIN, a number of methods have been proposed to be effective. Among them, alkalinization of urine takes an important place. Although the Na/K citrate is a well-known agent for urine alkalinization, it has not been studied in the prevention of CIN.

METHODS AND RESULTS:

Two hundred and two patients who underwent coronary angiography were included in the study. They were randomized into groups receiving the drug Na/K citrate per os and to the control group. Serum creatinine and glomerular filtration rate were determined in all patients immediately before coronary angiography, and 48 h after the procedure. CIN criteria were a creatinine increase of >25%, reduction in the glomerular filtration rate by >25%, or an increase in serum creatinine of >44 ╬╝mol/L. The incidence of CIN in the group receiving Na/K citrate was significantly lower when compared with the control group (4% compared with 20%, P = 0.0001). Patients who had a urine pH <6 had a more than ten-fold higher incidence of contrast nephropathy compared with patients whose urine pH was >6.

CONCLUSION:

Alkalinization of urine using the Na/K citrate may reduce the incidence of CIN.

KEYWORDS:

Alkalinization; Citrate; Contrast-induced nephropathy; Urine

PMID:
23349296
DOI:
10.1093/eurheartj/eht009
[Indexed for MEDLINE]
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