Faculty Opinions recommendation of Sodium bicarbonate therapy for prevention of contrast-induced nephropathy: a systematic review and meta-analysis.

Abstract Background Metabolic acidosis is a prevalent condition in patients with chronic kidney disease (CKD). Although sodium bicarbonate is extensively used for management of metabolic acidosis, its efficacy has not been summarized in previous review studies. Objective To conduct a systematic review and meta-analysis to estimate the overall effects of sodium bicarbonate on indices of renal function in patients with CKD. Methods A systematic literature search was carried out through the Medline, Web of Science and Scopus databases, up to July 2020. Studies that reported the effects of oral sodium bicarbonate administration on renal function were included. Blood urea nitrogen (BUN), serum creatinine, glomerular filtration rate (GFR), and creatinine clearance were defined as renal function indices. A random-effects model was used to calculate the overall effect and reported as weighted mean difference (WMD). Results Thirteen studies were included in this systematic review and meta-analysis. A beneficial effect of sodium bicarbonate was observed on BUN (WMD: − 8.63 mg/dL; 95% CI: -11.08, -6.19), serum creatinine (WMD: -0.19 mg/dL; 95% CI: -0.36, -0.02), GFR (WMD: 0.75 ml/min/1.73 m2; 95% CI: 0.14, 1.35), and creatinine clearance (WMD: 4.82 mL/min; 95% CI: 2.68, 6.96). There was no between study heterogeneity for all renal function indices. Also, no publication bias was observed in this study. Conclusion This systematic review and meta-analysis showed that sodium bicarbonate supplementation could increase GFR and creatinine clearance and decrease BUN and creatinine. Therefore, sodium bicarbonate therapy may efficacious in ameliorating the progression of CKD.

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Strategies Preventing Contrast-Induced Nephropathy After Coronary Angiography: A Comprehensive Meta-Analysis and Systematic Review of 125 Randomized Controlled Trials

Angiology ◽

10.1177/0003319716661445 ◽

2016 ◽

Vol 68 (5) ◽

pp. 389-413 ◽

Cited By ~ 25

Author(s):

Sadegh Ali-Hassan-Sayegh ◽

Seyed Jalil Mirhosseini ◽

Zahra Ghodratipour ◽

Zahra Sarrafan-Chaharsoughi ◽

Elham Rahimizadeh ◽

...

Keyword(s):

Systematic Review ◽

Coronary Angiography ◽

Vitamin C ◽

Enzyme Inhibitors ◽

Meta Analysis ◽

Angiotensin Converting Enzyme Inhibitors ◽

Pooled Analysis ◽

Loop Diuretics ◽

Contrast Induced Nephropathy ◽

Converting Enzyme Inhibitors

This systematic review with meta-analysis sought to determine the strength of evidence for the effects of hydration (sodium bicarbonate [SB] and normal saline [NS]), supplementations ( N-acetylcysteine [NAC] and vitamin C), and some common drugs (adenosine antagonists [AAs], statins, loop diuretics, and angiotensin-converting enzyme inhibitors [ACEIs]) on the incidence of contrast-induced nephropathy (CIN) and requirement for hemodialysis after coronary angiography. After screening, a total of 125 trials that reported outcomes were identified. Pooled analysis indicated beneficial effects of SB versus NS (odds ratio [OR] = 0.73; 95% confidence interval [CI]: 0.56-0.94; P = .01), NAC (OR = 0.79; 95% CI: 0.70-0.88; P = .001), vitamin C (OR = 0.64; 95% CI: 0.45-0.89; P = .01), statins (OR = 0.45; 95% CI: 0.35-0.57; P = .001), AA (OR = 0.28; 95% CI: 0.14-0.47; P = .001), loop diuretics (OR = 0.97; 95% CI: 0.33-2.85; P = .9), and ACEI (OR = 1.06; 95% CI: 0.69-1.61; P = .8). Overall, hydration with SB, use of supplements, such as NAC and vitamin C, and administration of statins and AA should always be considered for the prevention of CIN after coronary angiography.

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Isolated ingestion of caffeine and sodium bicarbonate on repeated sprint performance: A systematic review and meta-analysis

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2019.03.007 ◽

2019 ◽

Vol 22 (8) ◽

pp. 962-972 ◽

Cited By ~ 2

Author(s):

João P. Lopes-Silva ◽

Hui C. Choo ◽

Emerson Franchini ◽

Chris R. Abbiss

Keyword(s):

Systematic Review ◽

Sodium Bicarbonate ◽

Meta Analysis ◽

Sprint Performance ◽

Repeated Sprint

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Effects of Sodium Bicarbonate Supplementation on Muscular Strength and Endurance: A Systematic Review and Meta-analysis

Sports Medicine ◽

10.1007/s40279-020-01275-y ◽

2020 ◽

Vol 50 (7) ◽

pp. 1361-1375 ◽

Cited By ~ 4

Author(s):

Jozo Grgic ◽

Ramon F. Rodriguez ◽

Alessandro Garofolini ◽

Bryan Saunders ◽

David J. Bishop ◽

...

Keyword(s):

Systematic Review ◽

Sodium Bicarbonate ◽

Muscular Strength ◽

Meta Analysis

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Isolated effects of caffeine and sodium bicarbonate ingestion on performance in the Yo-Yo test: A systematic review and meta-analysis

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2019.08.016 ◽

2020 ◽

Vol 23 (1) ◽

pp. 41-47 ◽

Cited By ~ 6

Author(s):

Jozo Grgic ◽

Alessandro Garofolini ◽

Craig Pickering ◽

Michael J. Duncan ◽

Grant M. Tinsley ◽

...

Keyword(s):

Systematic Review ◽

Sodium Bicarbonate ◽

Meta Analysis

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Oral Bicarbonate Therapy in Non-Haemodialysis Dependent Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis of Randomised Controlled Trials

Journal of Clinical Medicine ◽

10.3390/jcm8020208 ◽

2019 ◽

Vol 8 (2) ◽

pp. 208 ◽

Cited By ~ 8

Author(s):

May Khei Hu ◽

Miles D. Witham ◽

Roy L. Soiza

Keyword(s):

Systematic Review ◽

Chronic Kidney Disease ◽

Metabolic Acidosis ◽

Kidney Disease ◽

Randomised Controlled Trials ◽

Meta Analysis ◽

Mean Difference ◽

Controlled Trials ◽

Bicarbonate Therapy ◽

Randomised Controlled

Metabolic acidosis is a common complication in chronic kidney disease (CKD) patients, and is associated with an accelerated decline in renal function. Oral bicarbonate therapy has been used to counteract metabolic acidosis in CKD for decades. However, until recently, there have been very few intervention studies testing the effectiveness of bicarbonate therapy at improving metabolic acidosis or its consequences in patients with CKD. In this systematic review and meta-analysis, we aimed to examine the outcomes of all published randomised controlled trials (RCTs) that investigated the effect of oral bicarbonate therapy in adults with CKD. Ovid MEDLINE®, EMBASE® and Cochrane Library were searched in mid-October 2018 for English literature, with no restrictions applied to the publication status or date. Seven RCTs that recruited 815 participants met our inclusion criteria after full text review. Oral bicarbonate supplementation resulted in a slightly higher estimated glomerular filtration rate (eGFR) (mean difference 3.1 mL/min per 1.73 m2; 95% CI 1.3–4.9) and serum bicarbonate levels (mean difference 3.4 mmol/L; 95% CI 1.9–4.9) at the end of follow-up (three months to five years) compared to those given placebo or conventional CKD treatment. When limited to studies reporting outcomes at one year, the positive effect of oral bicarbonate therapy on eGFR was attenuated. There were no significant treatment effects in other parameters such as systolic blood pressure (BP) and weight. These findings should be interpreted with caution and further trial evidence is needed to establish the net overall benefit or harm of oral bicarbonate therapy in CKD.

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