In this meta-analysis of 12 trials with over 1800 participants, HCo3 reduced the risk of contrast induced nephropathy (CIN) compared to controls (OR 0.46, CI 0.26-0.82) and compared to normal saline (OR 0.39, CI 0.2-0.8), but not compared to N-acetylcysteine / normal saline combination. It also did not reduce the need for renal replacement therapy, in hospital death, or CHF in any of the subgroups. Although Hco3 can reduce the incidence of CIN (compared to controls or saline), it’s clinical significance is still unclear (abstract).
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