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Prevention of Contrast-Induced Nephropathy With Sodium Bicarbonate: An Evidence-Based Protocol

Merten, Gregory J. MD*; Burgess, W Patrick MD, PhD; Rittase, Robert A. PharmD; Kennedy, Thomas P. MD, MPH§

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine: September 2004 - Volume 3 - Issue 3 - p 138-143
doi: 10.1097/01.hpc.0000137152.52554.76
Original Contributions: Original Article

Contrast-induced nephropathy has continued to plague interventional cardiology as an all-too-frequent complication of diagnostic and therapeutic procedures. We present an evidence-based protocol for prevention of this complication that uses infusion of NaHCO3 to effect urinary alkalinization and possibly decrease free-radical renal injury resulting from contrast exposure.

From the *Division of Nephrology, Mayo Clinic, Rochester, Minnesota; †Metrolina Nephrology Associates, Charlotte, North Carolina; the ‡Clinical Pharmacy, Carolinas Medical Center, Charlotte, North Carolina; and the §Department of Internal Medicine and Cannon Research Center, Carolinas Medical Center, Charlotte, North Carolina.

Reprints: Thomas P. Kennedy, MD, MPH, Department of Internal Medicine, Carolinas Medical Center, MEB 507, P.O. Box 32861, Charlotte, NC 28232. E-mail:

© 2004 Lippincott Williams & Wilkins, Inc.