• Judith L Kristeller, Gerald S Zavorsky, John E Prior, Doris A Keating, Mary Ann Brady, Theresa A Romaldini, Tiera L Hickman, and Russell F Stahl.
• Department of Pharmacy Practice, School of Pharmacy, Wilkes University, Wilkes-Barre, Pennsylvania 18766, USA. Judith.kristeller@wilkes.edu
• Pharmacotherapy. 2013 Jul 1;33(7):710-7.

Study ObjectiveBecause alkalinization of the renal tubules can theoretically protect against the mechanisms of acute kidney injury, we sought to determine whether a sodium bicarbonate infusion can prevent acute kidney injury after cardiac surgery.DesignProspective, randomized, double-blind, controlled trial.SettingCardiac surgery service in a community hospital.PatientsNinety-two patients with stage 3 or higher chronic kidney disease who underwent cardiac surgery using cardiopulmonary bypass.InterventionForty-eight patients received a perioperative intravenous infusion of 0.9% sodium chloride 154 mEq/L, and 44 patients received an infusion of sodium bicarbonate infusion 150 mEq/L in 5% dextrose solution; the infusions were started 1 hour preoperatively and continued for 6 hours after cardiopulmonary bypass.Measurements And Main ResultsThe primary outcome was the development of any stage of acute kidney injury within 5 days after surgery as defined by the Acute Kidney Injury Network criteria. No statistically significant difference in the primary outcome was noted between the two groups: 32% in the bicarbonate group versus 42% in the sodium chloride group (p=0.12). Likewise, no significant differences in the 30-day hospital mortality rate or other adverse outcomes were noted between the two groups.ConclusionA perioperative infusion of sodium bicarbonate did not reduce the rate of acute kidney injury or adverse outcomes in patients with chronic kidney disease who underwent cardiac surgery.© 2013 Pharmacotherapy Publications, Inc.

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