Trial for Prevention of Contrast Nephropathy With Sodium Bicarbonate

This study has been completed.
Information provided by (Responsible Party):
Kaiser Permanente Identifier:
First received: April 5, 2006
Last updated: March 10, 2015
Last verified: March 2015

Contrast nephropathy (CN) is a common cause of renal failure associated with prolonged hospitalization, significant morbidity/mortality, and cost. In addition, these patients may require temporary or permanent hemodialysis which, in turn, is associated with further morbidity, mortality, and cost. CN has been reported to account for 10% of hospital acquired renal failure. In recent years, studies have investigated preventive therapies with mixed results. Fenoldopam was found to be ineffective in a large randomized trial. Dopamine has been shown to be ineffective as a preventive strategy. Hemofiltration has been shown to be beneficial (New England Journal of Medicine [NEJM] 2003) but is costly and not practical. Mucomyst has shown mixed results. The single strategy which most would agree as being beneficial remains hydration, most commonly with intravenous 0.9% normal saline. Most recently, sodium bicarbonate has been shown to be beneficial in a small randomized trial (n=119). It is clear that the most cost effective strategies for treatment of CN should be aimed at prevention.

The general question is: "Is a sodium bicarbonate solution more efficacious in preventing contrast nephropathy compared to normal saline?" The general hypothesis is that sodium bicarbonate will be more efficacious.

Condition Intervention Phase
Contrast Induced Nephropathy
Kidney Diseases
Drug: Sodium bicarbonate
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Official Title: A Randomized Trial for Prevention of Contrast Nephropathy With Sodium Bicarbonate

Resource links provided by NLM:

Further study details as provided by Kaiser Permanente:

Primary Outcome Measures:
  • development of contrast induced nephropathy, defined by a decrease in glomerular filtration rate (GFR) by 25% or more

Secondary Outcome Measures:
  • change in serum creatinine
  • difference in hospital duration between groups
  • need for hemodialysis
  • 30 day mortality
  • difference of baseline to lowest GFR and highest creatinine between groups
  • difference in GFR and creatinine from baseline and 2-8 weeks later

Estimated Enrollment: 300
Study Start Date: January 2006
Study Completion Date: February 2006

Ages Eligible for Study:   18 Years and older
Genders Eligible for Study:   Both

Inclusion Criteria:

  • GFR < 60 mL/min/1.73m2. GFR will be adjusted by a correction factor as reported by our laboratory for patients self identifying as black.
  • > 18 years and have at least one of the following risk factors for contrast nephropathy: diabetes (type 2), congestive heart failure, hypertension (> 140/90), or age > 75.
  • Both inpatients and outpatients will be offered enrollment.

Exclusion Criteria:

  • Patients unable to give consent
  • Already receiving sodium bicarbonate solution
  • Undergoing emergency cardiac catheterization
  • Receiving a contrast agent other than Oxilan
  • On hemodialysis
  • Recent exposure to contrast within 2 days
  • Pulmonary edema
  • Active congestive heart failure
  • Severe valvular abnormality
  • Recent significant change in kidney function (> 15% over 2d)
  • One kidney
  • Kidney transplant status
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Please refer to this study by its identifier: NCT00312117

United States, California
Kaiser Permanente Medical Center
Los Angeles, California, United States, 90027
Sponsors and Collaborators
Kaiser Permanente
Principal Investigator: Somjot S Brar, M.D. Kaiser Permanente Southern California
  More Information

Additional publications automatically indexed to this study by Identifier (NCT Number):
Responsible Party: Kaiser Permanente Identifier: NCT00312117     History of Changes
Other Study ID Numbers: 4353
Study First Received: April 5, 2006
Last Updated: March 10, 2015
Health Authority: United States: Institutional Review Board

Keywords provided by Kaiser Permanente:
contrast induced nephropathy
sodium bicarbonate
cardiac catheterization

Additional relevant MeSH terms:
Kidney Diseases
Urologic Diseases processed this record on November 30, 2015