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January 28, 2009, Vol 301, No. 4 >

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Letters | January 28, 2009

Sodium Bicarbonate vs Sodium Chloride in Preventing Contrast Medium–Induced Nephropathy

Bradley D. Shy, MD; Amit Gupta, MD; Robert S. Hoffman, MD
JAMA. 2009;301(4):377-380. doi:10.1001/jama.2009.17.
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To the Editor: Dr Brar and colleagues1 studied the use of sodium bicarbonate to prevent CIN. If effective, sodium bicarbonate would be a readily available, inexpensive, and safe means to prevent a common iatrogenic cause of renal damage. In interpreting this study, several aspects of the design introduced differences between the intervention and control groups beyond the type of fluid administered.

By choosing to mix sodium bicarbonate into a dextrose solution (instead of into sterile water), the researchers created a hyperosmolar fluid. The dextrose and bicarbonate solution given to the intervention group had 478 mOsm/L while the normal saline given to the control group had a physiologic osmolarity of 310 mOsm/L. The hyperosmolar nature of the fluid given to the bicarbonate group could have potentially obscured any benefit of bicarbonate on glomerular flow rate.2

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

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January 28, 2009
Sodium Bicarbonate vs Sodium Chloride in Preventing Contrast Medium–Induced Nephropathy
William Burgess, MD, PhD; Gregory J. Merten, MD; Robert A. Rittase, PharmD
JAMA. 2009;301(4):377-380. doi:10.1001/jama.2009.16.
January 28, 2009
Sodium Bicarbonate vs Sodium Chloride in Preventing Contrast Medium–Induced Nephropathy
Mehmet Kanbay, MD; Benan Kasapoglu, MD; Ali Akcay, MD
JAMA. 2009;301(4):377-380. doi:10.1001/jama.2009.18.
January 28, 2009
Sodium Bicarbonate vs Sodium Chloride in Preventing Contrast Medium–Induced Nephropathy
Alberto Bouzas-Mosquera, MD; José M. Vázquez-Rodríguez, MD; Jesús Peteiro, MD, PhD
JAMA. 2009;301(4):377-380. doi:10.1001/jama.2009.19.
January 28, 2009
Sodium Bicarbonate vs Sodium Chloride in Preventing Contrast Medium–Induced Nephropathy—Reply
Somjot S. Brar, MD; Albert Yuh-Jer Shen, MD; Michael B. Jorgensen, MD
JAMA. 2009;301(4):377-380. doi:10.1001/jama.2009.20.
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