JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
 QUICK SEARCH:   [advanced]


     


J Am Coll Cardiol, 2007; 49:1283-1288, doi:10.1016/j.jacc.2006.11.034 (Published online 9 March 2007).
© 2007 by the American College of Cardiology Foundation
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
j.jacc.2006.11.034v1
49/12/1283    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Recio-Mayoral, A.
Right arrow Articles by Cruz, J. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Recio-Mayoral, A.
Right arrow Articles by Cruz, J. M.

CLINICAL RESEARCH: CLINICAL TRIAL

The Reno-Protective Effect of Hydration With Sodium Bicarbonate Plus N-Acetylcysteine in Patients Undergoing Emergency Percutaneous Coronary Intervention

The RENO Study

Alejandro Recio-Mayoral, MD*,*, Marinela Chaparro, MD*, Belén Prado, MD*, Rocío Cózar, MD*, Irene Méndez, MD*, Debasish Banerjee, MD, MRCP{dagger}, Juan C. Kaski, MD, DM, DSc{ddagger}, José Cubero, MD* and Jose M. Cruz, MD*

* Department of Cardiology, Virgen Macarena University Hospital, Seville, Spain
{dagger} Department of Renal and Transplantation
{ddagger} Division of Cardiac and Vascular Sciences, St. George's Hospital, University of London, London, United Kingdom

Manuscript received August 16, 2006; revised manuscript received November 1, 2006, accepted November 16, 2006.

* Reprint requests and correspondence: Dr. Alejandro Recio-Mayoral, Division of Cardiac and Vascular Sciences, St. George's Hospital, University of London, Cranmer Terrace, London SW17 0RE, United Kingdom. (Email: arecio{at}sgul.ac.uk).

Objectives: This study was designed to determine the effectiveness of a protocol for rapid intravenous hydration to prevent contrast-induced nephropathy (CIN) in patients undergoing emergency percutaneous coronary intervention (PCI).

Background: Contrast-induced nephropathy frequently complicates PCI, resulting in prolonged hospitalization and increased in-hospital and long-term morbidity and mortality. Little is known regarding prevention of CIN in patients undergoing urgent PCI.

Methods: We conducted a prospective, controlled, randomized, single-center trial in 111 consecutive patients with acute coronary syndrome undergoing emergency PCI. As part of the hydration therapy, 56 patients (group A) received an infusion of sodium bicarbonate plus N-acetylcysteine (N-AC) started just before contrast injection and continued for 12 h after PCI. The remaining 55 patients (group B) received the standard hydration protocol consisting of intravenous isotonic saline for 12 h after PCI. In both groups, 2 doses of oral N-AC were administered the next day.

Results: The 2 groups were similar with respect to age, gender, diabetes mellitus, and baseline serum creatinine. A serum creatinine concentration >0.5 mg/dl from baseline after emergency PCI was observed in 1 patient in group A (1.8%) and in 12 patients in group B (21.8%; p < 0.001). Acute anuric renal failure was observed in 1 patient (1.8%) in group A and in 7 patients (12.7%) in group B (p = 0.032).

Conclusions: Rapid intravenous hydration with sodium bicarbonate plus N-AC before contrast injection is effective and safe in the prevention of CIN in patients undergoing emergency PCI.

Abbreviations and Acronyms
  ACS = acute coronary syndrome
  BUN = blood urea nitrogen
  CI = confidence interval
  CIN = contrast-induced nephropathy
  GFR = glomerular filtration rate
  N-AC = N-acetylcysteine
  OR = odds ratio
  PCI = percutaneous coronary intervention
  SCr = serum creatinine




This article has been cited by other articles:


Home page
J Am Coll CardiolHome page
M. Maioli, A. Toso, M. Leoncini, M. Gallopin, D. Tedeschi, C. Micheletti, and F. Bellandi
Sodium Bicarbonate Versus Saline for the Prevention of Contrast-Induced Nephropathy in Patients With Renal Dysfunction Undergoing Coronary Angiography or Intervention
J. Am. Coll. Cardiol., August 19, 2008; 52(8): 599 - 604.
[Abstract] [Full Text] [PDF]


Home page
Am. J. Roentgenol.Home page
D. A. Baumgarten and J. H. Ellis
Contrast-Induced Nephropathy: Contrast Material Not Required?
Am. J. Roentgenol., August 1, 2008; 191(2): 383 - 386.
[Abstract] [Full Text] [PDF]


Home page
Arch Intern MedHome page
S. D. Weisbord, M. K. Mor, A. L. Resnick, K. C. Hartwig, A. F. Sonel, M. J. Fine, and P. M. Palevsky
Prevention, Incidence, and Outcomes of Contrast-Induced Acute Kidney Injury
Arch Intern Med, June 23, 2008; 168(12): 1325 - 1332.
[Abstract] [Full Text] [PDF]


Home page
J Am Coll CardiolHome page
S. R. Dixon, C. L. Grines, and W. W. O'Neill
The year in interventional cardiology.
J. Am. Coll. Cardiol., June 17, 2008; 51(24): 2355 - 2369.
[Full Text] [PDF]


Home page
J Am Coll CardiolHome page
A. N. DeMaria, J. J. Bax, O. Ben-Yehuda, P. Clopton, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, J. D. Knoke, W. Y.W. Lew, J. A.C. Lima, et al.
Highlights of the year in JACC 2007.
J. Am. Coll. Cardiol., January 29, 2008; 51(4): 490 - 512.
[Full Text] [PDF]


Home page
Nephrol Dial TransplantHome page
A. X. Garg, T. Greene, and N. W. Levin
A well-conducted randomized trial that establishes no benefit of therapy is an important medical advance
Nephrol. Dial. Transplant., January 1, 2008; 23(1): 52 - 55.
[Full Text] [PDF]


Home page
CJASNHome page
A. M. From, B. J. Bartholmai, A. W. Williams, S. S. Cha, A. Pflueger, and F. S. McDonald
Sodium Bicarbonate is Associated with an Increased Incidence of Contrast Nephropathy: A Retrospective Cohort Study of 7977 Patients at Mayo Clinic
Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 10 - 18.
[Abstract] [Full Text] [PDF]


Home page
CJASNHome page
S. D. Weisbord and P. M. Palevsky
Prevention of Contrast-Induced Nephropathy with Volume Expansion
Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 273 - 280.
[Abstract] [Full Text] [PDF]




HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 2007 by the American College of Cardiology Foundation.