Clinical Trial of Sodium Bicarbonate to Prevent Contrast-Induced Nephropathy

NCT ID: NCT00424320

Last Updated: 2007-01-19

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

PHASE3

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-10-31

Study Completion Date

2007-01-31

Brief Summary

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The purpose of this study is to determine whether sodium bicarbonate is effective in the prevention of sodium-induced nephropathy

Detailed Description

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The use of contrast media is more frequent as new diagnostic and therapeutic procedures are developed. As a consequence, the occurrence of acute renal failure (ARF), also known as contrast-induced nephropathy, is more frequently seen after the realization of these procedures, representing about 10% of all in-hospital ARF. The importance of preventing this complication is related with its strong association with higher morbidity and mortality rates in patients who present it. A number of drugs and interventions have been studied for preventing contrast-induced nephropathy, including intravenous hydration with normal and hypotonic saline solutions, oral hydration, mannitol, diuretics, dopamine and its antagonists (fenoldopam), calcium antagonists, theophylline, N-acetylcysteine, natriuretic atrial peptide and hemodialysis after or during contrast media administration.

There is only one study in humans that demonstrates the utility of the sodium bicarbonate to prevent the contrast-induced nephropathy, showing a reduction in the incidence of this complication of about 13.6%. Although this result could seem convincing, its relevance has been questioned because the definition used by the authors as contrast-induced nephropathy was an increase of 25% from basal creatinine. Although when compared, the absolute differences between basal and after-procedure creatinines were not statistically significative, the sample size was small and the participants were low-risk patients to develop contrast-induced nephropathy. It is also important to note that the control group was hydrated with a dextrose 5% solution with 154 mEq of NaCl, although today's most accepted prevention therapy is intravenous hydration with normal saline solution.

Comparison: Hydration previously, during and afterwards contrast media administration with normal saline solution (0.9%), compared to hydration previous, during and afterwards contrast media administration with a solution made of normal saline and sodium bicarbonate.

Conditions

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Acute Kidney Failure

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Interventions

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Sodium bicarbonate

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* Age over 18 years old
* Indication for coronariography and/or percutaneous coronary intervention
* Voluntary written consent for the realization of coronariography and/or percutaneous intervention and for the participation in this clinical trial
* A MEHRAN contrast-induced nephropathy score of six or more

Exclusion Criteria

* Patients with chronic kidney failure requiring any kind of dialysis
* Patients unable to complete follow-up
* Multiple myeloma
* Exposure to contrast 48 hours prior to study
* Pregnancy
* Patients unable to give consent
* Already receiving sodium bicarbonate solutions
* Receiving contrast media other than non-ionic
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Instituto Nacional de Cardiologia Ignacio Chavez

OTHER

Sponsor Role lead

Principal Investigators

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Emma Miranda Malpica, PhD

Role: PRINCIPAL_INVESTIGATOR

Ignacio Chávez National Institute of Cardiology

Marco A Martínez Ríos, MD, FACC

Role: STUDY_DIRECTOR

Ignacio Chávez National Institute of Cardiology

Jorge Gaspar Hernández, MD

Role: STUDY_CHAIR

Ignacio Chávez National Institute of Cardiology

Locations

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ABC Medical Center

Mexico City, Mexico City (d.f.), Mexico

Site Status RECRUITING

Ignacio Chávez National Institute of Cardiology

Mexico City, Mexico City (d.f:), Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Emma Miranda Malpica, PhD

Role: CONTACT

52+55+55499120 ext. 1232

Facility Contacts

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Jesús Simón Domínguez, PharmD

Role: primary

52+55+52308098

Emma M Miranda Malpica, MD, PhD

Role: primary

52+55+55732911 ext. 1236

References

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Bagshaw SM, Ghali WA. Acetylcysteine for prevention of contrast-induced nephropathy after intravascular angiography: a systematic review and meta-analysis. BMC Med. 2004 Oct 22;2:38. doi: 10.1186/1741-7015-2-38.

Reference Type BACKGROUND
PMID: 15500690 (View on PubMed)

Itoh Y, Yano T, Sendo T, Oishi R. Clinical and experimental evidence for prevention of acute renal failure induced by radiographic contrast media. J Pharmacol Sci. 2005 Apr;97(4):473-88. doi: 10.1254/jphs.crj05002x. Epub 2005 Apr 9.

Reference Type BACKGROUND
PMID: 15821342 (View on PubMed)

Aspelin P. Nephrotoxicity and the role of contrast media. Radiat Med. 2004 Nov-Dec;22(6):377-8. No abstract available.

Reference Type BACKGROUND
PMID: 15648451 (View on PubMed)

Mueller C, Seidensticker P, Buettner HJ, Perruchoud AP, Staub D, Christ A, Buerkle G. Incidence of contrast nephropathy in patients receiving comprehensive intravenous and oral hydration. Swiss Med Wkly. 2005 May 14;135(19-20):286-90. doi: 10.4414/smw.2005.10938.

Reference Type BACKGROUND
PMID: 15986266 (View on PubMed)

Goldenberg I, Matetzky S. Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies. CMAJ. 2005 May 24;172(11):1461-71. doi: 10.1503/cmaj.1040847.

Reference Type BACKGROUND
PMID: 15911862 (View on PubMed)

Cavusoglu E, Chhabra S, Marmur JD, Kini A, Sharma SK. The prevention of contrast-induced nephropathy in patients undergoing percutaneous coronary intervention. Minerva Cardioangiol. 2004 Oct;52(5):419-32.

Reference Type BACKGROUND
PMID: 15514576 (View on PubMed)

Rezkalla SH. Contrast nephropathy. Clin Med Res. 2003 Oct;1(4):301-4. doi: 10.3121/cmr.1.4.301.

Reference Type BACKGROUND
PMID: 15931323 (View on PubMed)

Merten GJ, Burgess WP, Gray LV, Holleman JH, Roush TS, Kowalchuk GJ, Bersin RM, Van Moore A, Simonton CA 3rd, Rittase RA, Norton HJ, Kennedy TP. Prevention of contrast-induced nephropathy with sodium bicarbonate: a randomized controlled trial. JAMA. 2004 May 19;291(19):2328-34. doi: 10.1001/jama.291.19.2328.

Reference Type BACKGROUND
PMID: 15150204 (View on PubMed)

Briguori C, Airoldi F, Morici N, Colombo A. New pharmacological protocols to prevent or reduce contrast media nephropathy. Minerva Cardioangiol. 2005 Feb;53(1):49-58.

Reference Type BACKGROUND
PMID: 15788979 (View on PubMed)

Related Links

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http://www.cardiologia.org.mx

National Institute of Cardiology

Other Identifiers

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06-001

Identifier Type: -

Identifier Source: org_study_id

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