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Prevention of Contrast Induced Nephropathy With Sodium Bicarbonate
This study is not yet open for participant recruitment.
Study NCT00392405   Information provided by Norton Community Hospital
First Received: October 25, 2006   No Changes Posted
This Tabular View shows the required WHO registration data elements as marked by

October 25, 2006
October 25, 2006
November 2006
Development of contrast-induced nephropathy, defined as an increase in serum creatinine of 25% or more within 2 day after administration of contrast
Same as current
No Changes Posted
  • change in mean arterial pressure after initial bolus, mmHg
  • urine pH after initial bolus
  • contrast volume
  • change in serum bicarbonate
  • change in serum potassium
  • change in serum glucose
  • change in serum creatinine
  • change in estimated glomerular filtration rate
  • incidence of contrast induced nephropathy
Same as current
 
Prevention of Contrast Induced Nephropathy With Sodium Bicarbonate
Prevention of Contrast Induced Nephropathy With Sodium Bicarbonate

This will be a randomized controlled trial closely following the original protocol in the previous study published in JAMA 2004 by Merten et al. Patients will be randomly assigned to one of two treatment groups. Treatment group A will receive 1cc/kg/hour of 0.9% normal saline at least 2 hours prior to study beginning and will be continued during and for 6 hours post contrast. Treatment group B will receive 3cc/kg of sodium bicarbonate solution for one hour prior to procedure then drip rate will be decreased to 1cc/kg/hour during and for 6 hours post procedure. The sodium bicarbonate solution will be made by adding 3 amps of bicarbonate to 1L of D5W. Patients in both treatment arms weighing >110kg the initial fluid bolus and drip will be limited to those patients weighing 110kg. In both treatment arms, diuretics will be held before and after contrast administration on the day of the study. BMP will be checked the day of, 24 and 48 hours post contrast administration. The greatest change in all readings will be used for treatment comparisons.

Contrast induced nephropathy will be defined as a change in serum creatinine of more than 25% from baseline and/or 0.5mg/dL. Urinary pH will also be measured on first spontaneous void following bolus. Vital signs including blood pressure and oxygen saturation will be documented every 4 hours to monitor patients closely for signs and symptoms of volume overload

Inclusion Criteria:

  • Stage III Chronic Kidney Disease (GFR 30-60ml/min per 1.73m2 calculated by using MDRD equation)
  • Inpatients at Norton Community Hospital scheduled to undergo diagnostic CT Scan using contrast between the hours of 7am and 6pm
  • 18+ years of age

Exclusion Criteria

  • Current clinical diagnosis of exacerbated congestive heart failure
  • Creatinine >8 mg/dL
  • Change in serum Cre of at least 0.5mg/dL during previous 24hours
  • Pre-existing dialysis patient
  • Multiple myeloma
  • Uncontrolled hypertension (definition: treated SBP >160mmHg or DBP >100mmHg
  • Exposure to contrast 48 hours prior to study
  • Allergy to contrast dye
  • Pregnancy
  • Patient has received pressor agents, fendolapam, mannitol, or mucomyst at time of study
  • Acute myocardial infarction

Subjects: Consecutive samples of all CPSC inpatients who meet the above inclusion criteria

Allocation Assignment: Patients who meet inclusion criteria and agree to participate in the study will pick a concealed number out of an open envelope.

That number (between 1- 656) will correlate with a number on a sealed opaque envelope. Inside the opaque envelope will be a chart sticker. The chart sticker will have the words either normal saline or sodium bicarbonate. The envelope will not be opened until all patient information (ie. Patient ID sticker) is placed on the original chosen envelope. Then the chart sticker will be removed and placed on the chart

Protocol Outline:

This will be a randomized controlled trial closely following the original protocol in the previous study. Patients will be randomly assigned to one of two treatment groups. Treatment group A will receive 1cc/kg/hour of 0.9% normal saline at least 2 hours prior to study beginning and will be continued during and for 6 hours post contrast. Treatment group B will receive 3cc/kg of sodium bicarbonate solution for one hour prior to procedure then drip rate will be decreased to 1cc/kg/hour during and for 6 hours post procedure. The sodium bicarbonate solution will be made by adding 3 amps of bicarbonate to 1L of D5W. Patients in both treatment arms weighing >110kg the initial fluid bolus and drip will be limited to those patients weighing 110kg. In both treatment arms, diuretics will be held before and after contrast administration on the day of the study. BMP will be checked the day of, 24 and 48 hours post contrast administration. The greatest change in all readings will be used for treatment comparisons. Contrast induced nephropathy will be defined as a change in serum creatinine of more than 25% from baseline and/or 0.5mg/dL. Urinary pH will also be measured on first spontaneous void following bolus. Vital signs including blood pressure and oxygen saturation will be documented every 4 hours to monitor patients closely for signs and symptoms of volume overload

Phase II
Interventional
Prevention, Randomized, Open Label, Active Control, Parallel Assignment, Efficacy Study
Contrast Induced Nephropathy
Drug: 3 amps of sodium bicarbonate mixed in one liter of D5W
 

*   Includes publications given by the data provider as well as publications identified by National Clinical Trials Identifier (NCT ID) in Medline.
 
Not yet recruiting
656
 
 

Inclusion Criteria:

  • Stage III Chronic Kidney Disease (GFR 30-60ml/min per 1.73m2 calculated by using MDRD equation)
  • Inpatients at Norton Community Hospital scheduled to undergo diagnostic CT Scan using contrast between the hours of 7am and 6pm
  • 18+ years of age

Exclusion Criteria:

  • Exclusion Criteria
  • Current clinical diagnosis of exacerbated congestive heart failure
  • Creatinine >8 mg/dL
  • Change in serum Cre of at least 0.5mg/dL during previous 24hours
  • Pre-existing dialysis patient
  • Multiple myeloma
  • Uncontrolled hypertension (definition: treated SBP >160mmHg or DBP >100mmHg
  • Exposure to contrast 48 hours prior to study
  • Allergy to contrast dye
  • Pregnancy
  • Patient has received pressor agents, fendolapam, mannitol, or mucomyst at time of study
  • Acute myocardial infarction
Both
18 Years and older
No
Contact: Donna S Sanders, DO 276-708-7021 dsanders_nch@yahoo.com
United States
 
 
NCT00392405
 
 
Norton Community Hospital
 
Principal Investigator: Donna S Sanders, DO Norton Community Hospital
Study Director: Mathew Cusano, MD Norton Community Hospital
Norton Community Hospital
October 2006

 †    Required WHO trial registration data element.
††   WHO trial registration data element that is required only if it exists.