The 4 studies that concluded that the sodium bicarbonate-based hydration was ineffective included 2 studies conducted in the same institution around the same time. CX-4945 ic50 These 2 studies may contain duplicated data. There are 3 reports on sodium bicarbonate-based hydration in Japan. Ueda et al. [118] compared bolus saline infusion with bolus sodium bicarbonate infusion immediately before emergency PCI, and reported that sodium bicarbonate infusion significantly decreased the incidence of CIN by 88 % (RR: 0.128, 95 % CI: 0.016 ~ 0.91, p = 0.01). In a RCT of 144 patients with mild CKD undergoing an elective CAG, Tamura et al.

[119] reported that the incidence of CIN was lower in patients receiving standard saline hydration (12 h before contrast exposure) plus a single-bolus intravenous administration of 20 mEq/L sodium bicarbonate (MEYLON® 20 mL) immediately before contrast exposure than in patients receiving standard saline hydration alone (p = 0.017). Motohiro et al. [120] conducted a RCT in 155 patients and reported that the incidence of CIN in patients undergoing CAG was significantly lower in 78 patients who received 3 h of saline

hydration followed MM-102 research buy by 3 h of sodium bicarbonate-based hydration at 1 mL/kg/h prior to CAG and 6 h of sodium bicarbonate-based hydration after CAG than in 77 patients receiving saline hydration alone (p = 0.012). In the PREVENT study conducted in Korea, 382 patients with diabetes and CKD were randomly assigned Dichloromethane dehalogenase to receive saline hydration at 1 mL/kg/h for 12 h before and after CAG or PCI (saline group, n = 189), or sodium bicarbonate at 3 mL/kg/h for 1 h before contrast exposure and at 1 mL/kg/h from the initiation of the procedure to 6 h after the procedure (bicarbonate group, n = 193) [121]. All patients received oral NAC 1,200 mg twice daily for 2 days. The incidence of CIN was 5.3 % in the saline group and 9.0 % in the bicarbonate group, but the difference was not significant (p = 0.17). These

findings suggest that sodium bicarbonate is superior to saline in the prevention of CIN in patients who have only a limited time to receive intravenous infusion (e.g., patients requiring emergency care). However, sodium bicarbonate-based hydration does not significantly decrease the risks of hemodialysis and death, and is not concluded to be necessary. Is short-term intravenous hydration as effective as standard intravenous hydration in preventing CIN? Answer: Although there is no conclusive evidence on the efficacy of short-term intravenous hydration, we consider not to use short-term intravenous hydration because the incidence of CIN may be higher in those patients receiving short-term intravenous hydration than in those receiving standard intravenous hydration. It is difficult to conduct RCTs comparing short-term intravenous hydration (e.g.