OUTCOMES AFTER ANGIOGRAPHY WITH SODIUM BICARBONATE AND ACETYLCYSTEINE

Both “Intravenous Sodium Bicarbonate” and “Oral Acetylcysteine” are extensively utilized in the cure of acute injury of kidney and accompanying contrary results after angiography deprived of any proof of their effectiveness.

In this study we use the factorial design of 2-by-2 and casually assigned 5177 renal complications at high-risk stage patients, who also have scheduled for angiography while receiving 1.26% sodium bicarbonate through intravenous or sodium chloride 0.9% with five days oral placebo: from 5177 patients, 4993 were encompassed in the adapted objective to treat assessment. Death is the primary endpoint, dialysis requirement at 90 days; accordingly, acute kidney injury was our secondary endpoint.

Sponsor blocked the trial after interim analysis which was pre-specified. At the primary endpoint, there was no link between acetylcysteine and sodium bicarbonate (P=0.33). There was happening of primary endpoint in 110 patients from 2511 (which was 4.4%) in the group of sodium bicarbonate, if compared with 116 patients from 2482 (which was 4.7%) in the group of sodium chloride (at the odds ratio of 0.93, CI (confidence interval) 95%, 0.72 to 1.22; P=0.62) and 114 patients from 2495 patients (which was 4.6%) in the group of acetylcysteine with the comparison of 112 of 2498 patients (which was 4.5%) in the group of placebo (with specific odds ratio, 1.02: confidence interval (CI) 95%, 0.78 to 1.33 P=0.88).

There was basically no advantage of using intravenous sodium bicarbonate over the acetylcysteine, among the patients who were at high-level renal complication risk and who were experiencing angiography.

Keywords: Acute Kidney Injury, Angiography, Acetylcysteine, and Sodium Bicarbonate