KMID : 0882420110800050534
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Korean Journal of Medicine 2011 Volume.80 No. 5 p.534 ~ p.536
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Role of Intravenous Sodium Bicarbonate and Oral N-acetylcysteine in Radiocontrast-Induced Nephropathy
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Oh Dong-Jin
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Abstract
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Radiocontrast nephropathy (RCN) is one of the most common etiologies of hospital-acquired acute kidney injury (AKI), accounting for more than 10% of cases. There have been conflicting reports on the use of intravenous administration of sodium bicarbonate and oral N-acetylcysteine (NAC) for prevention of RCN. In this issue of the Journal, Koo et al compare the efficacy of sodium bicarbonate hydration with sodium chloride solution. They concluded that the efficacy of sodium bicarbonate hydration in the prevention of RCN seemed comparable to that of sodium chloride hydration. Oral NAC is safe and inexpensive. Therefore, we can propose that sodium bicarbonate or sodium chloride hydration with oral NAC in the prevention of RCN is probably effective, especially in CKD patients undergoing coronary procedure. However, additional large, multicenter, randomized, controlled trials will be required to define the true role of sodium bicarbonate and NAC in preventing RCN.
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KEYWORD
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Contrast media, Acute kidney injury, Sodium chloride, Sodium bicarbonate, Acetylcysteine
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