ORIGINAL RESEARCH article
Front. Pharmacol.
Sec. Renal Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1542776
This article is part of the Research TopicCell Death in Kidney Diseases: Novel Biomarkers, Mechanisms, and Therapeutic StrategiesView all 18 articles
Preventive effect of sodium bicarbonate Ringer's solution on postcontrast acute kidney injury in patients undergoing percutaneous coronary intervention
Provisionally accepted
- Shandong Provincial Hospital, Jinan, China
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Background: Post-contrast acute kidney injury (PC-AKI) is a common complication of coronary angiography (CAG) and percutaneous coronary interventions (PCI). Sodium bicarbonate Ringer's solution (BRS) has been shown to reduce the incidence of postoperative AKI and the risk of acidbase disorder in surgical and critically ill patients. There is no research data of BRS in the field of PC-AKI. Therefore, this study aimed to evaluate the efficacy and safety of BRS in the prevention of PC-AKI.Methods: Patients with coronary atherosclerotic heart disease and stage 2-3b chronic kidney disease (CKD) who underwent CAG or PCI were prospectively enrolled and randomly assigned to BRS group or normal saline (NS) group from February 2024 to October 2024. The patients were given BRS or NS for hydration at 1ml/kg/h from 3 hours before to 4 hours after CAG/PCI. Serum creatinine (Scr), cystatin C (Cys-C) and neutrophil gelatinase-associated apolipoprotein (NGAL)were measured within 3 days before and 48 hours after iodinated contrast agent exposure. The primary endpoint was PC-AKI, and the secondary endpoints were the need of renal replacement therapy (RRT) and major adverse cardiovascular events (MACEs) within 30 days after CAG/PCI.The correlation between BRS and PC-AKI was analyzed by multivariate logistic regression.The baseline characteristics of patients in the two groups were similar, and the changes of Cys-C, NGAL, and electrolytes before and after CAG/PCI were not statistically significant. PC-AKI occurred in 1 patient (1.3%) in BRS group and 7 patients (9.3%) in NS group, and the difference was statistically significant (P = 0.029). Multivariate logistic regression showed that there was an approaching statistical trend of BRS to reduce the incidence of PC-AKI (P = 0.054).Conclusions: BRS might be more suitable than NS in reducing the incidence of PC-AKI for patients with mild-to-moderate renal dysfunction who underwent CAG/PCI.
Keywords: Sodium bicarbonate Ringer's solution, contrast, Post-contrast acute kidney injury, hydration, Coronary Angiography, Percutaneous coronary interventions
Received: 10 Dec 2024; Accepted: 28 Aug 2025.
Copyright: © 2025 Liu, Zhao, Feng, Meng and Shang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Baobao Feng, Shandong Provincial Hospital, Jinan, China
Chong Meng, Shandong Provincial Hospital, Jinan, China
Deya Shang, Shandong Provincial Hospital, Jinan, China
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