To the Editor: In their randomized controlled trial, Dr Brar and colleagues1 found a lack of effectiveness of sodium bicarbonate in preventing CIN compared with saline. This study adds more controversy to the debate about what is the best strategy for CIN prevention. The authors discussed the results of 2 previous randomized trials that showed a remarkable benefit of sodium bicarbonate over saline for the prevention of CIN. However, the authors omitted a number of additional randomized studies evaluating the role of sodium bicarbonate in this setting that should have been taken into account in the discussion.
Bouzas-Mosquera A, Vázquez-Rodríguez JM, Peteiro J. Sodium Bicarbonate vs Sodium Chloride in Preventing Contrast Medium–Induced Nephropathy. JAMA. 2009;301(4):377-380. doi:10.1001/jama.2009.19