Skip to main content
  • Poster presentation
  • Open access
  • Published:

Perioperative sodium bicarbonate to prevent acute kidney injury after cardiac surgery: a multicenter double-blind randomized controlled trial

Introduction

Evidence suggests a nephroprotective effect of urinary alkalinization in patients at risk of acute kidney injury (AKI).

Methods

In a multicenter, double-blind, RCT we enrolled 350 adult cardiac surgery patients. At induction of anesthesia, patients received either 24 hours of intravenous infusion of sodium bicarbonate (5.1 mmol/kg) or sodium chloride (5.1 mmol/kg). The primary endpoint was the proportion of patients developing AKI.

Results

Sodium bicarbonate increased urinary pH (from 6.0 to 7.5, P 0.001). More patients in the bicarbonate group (83/174 (47.7%)) developed AKI compared with control (64/176 (36.4%), OR = 1.60 (95% CI, 1.04 to 2.45); unadjusted P = 0.032). A greater postoperative increase in urinary NGAL in patients receiving bicarbonate infusion was observed compared with control (P = 0.011). The incidence of postoperative RRT was similar but hospital mortality was increased in patients treated with bicarbonate compared with chloride (11/174 (6.3%) vs. 3/176 (1.7%), OR 3.89 (1.07 to 14.2), P = 0.031). See Figure 1.

Figure 1
figure 1

(abstract P413)

Conclusion

On this basis of our findings we do not recommend the use of perioperative infusions of sodium bicarbonate to reduce the incidence or severity of AKI in this patient group.

Author information

Authors and Affiliations

Authors

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article

Haase-Fielitz, A., Haase, M., Plass, M. et al. Perioperative sodium bicarbonate to prevent acute kidney injury after cardiac surgery: a multicenter double-blind randomized controlled trial. Crit Care 17 (Suppl 2), P413 (2013). https://doi.org/10.1186/cc12351

Download citation

  • Published:

  • DOI: https://doi.org/10.1186/cc12351

Keywords