Sodium bicarbonate treatment may not exactly protect patients from contrast-induced nephropathy (CIN), the kidney injury resulting from an injection administered in order improve x-ray image. CIN accounts for 10 per cent of all cases of acute kidney injury requiring hospitalisation.
While many of these people recover spontaneously, in its most severe form, CIN is associated with clinically significant morbidity and mortality, including prolonged hospitalisation, requirement for dialysis, and an increased risk of death. Sodium bicarbonate is supposed to mitigate the impact of the problematic injection.
Now an Ausralian study seems to say that previous research on the treatment might have overestimated its impact.
Lead author, Dr Sophia Zoungas, The George Institute said, " Our new comprehensive systematic review suggests that the benefits of sodium bicarbonate remain to be demonstrated. As such, we believe the routine use of sodium bicarbonate is premature. This is particularly important as this is a treatment that makes x-rays much more complicated and expensive than would otherwise be the case, not to mention using scarce hospital resources."
"Clinicians need to examine the quality of systematic reviews in order to determine whether the conclusions made are indeed accurate. Our review demonstrates that the comprehensive and methodical approach undertaken considerably altered the conclusions regarding the effects of this treatment," added Associate Professor Vlado Perkovic, The George Institute.
Researchers reviewed 9 published and 14 unpublished trials of sodium bicarbonate that included information on 3563 patients and 396 CIN events aiming to provide a reliable estimate of the nature and strength of any treatment effect. In the comprehensive meta-analysis, the research did not find clear evidence of overall benefit associated with the use of sodium bicarbonate to prevent CIN. The study also found that the inconsistency between previous findings highlighted the need for a high quality large trial that will clearly define the effects of intravenous sodium bicarbonate.
The new systematic review included more studies than previous research, and explored the results in more detail than ever before. Upon reviewing the research, researchers found that small early studies of lesser quality tended to suggest larger benefits, while more recent, larger and higher quality studies tended to find little or no benefit with the treatment.