The Particulars: Previous research on hydration choices during and after coronary angiography has not compared sodium bicarbonate and saline and has not examined their effect on preventing death, renal replacement therapy, or progressive kidney failure.

Data Breakdown: Patients enrolled in a trial who had an estimated GFR of 44 mL/min/1.73 m2 and who were undergoing angiography were randomized to receive sodium bicarbonate or saline for hydration. All-cause mortality was significantly lower for those who received sodium bicarbonate during coronary angiography than for those who received saline (3.2% vs 10.8%). However, no difference was seen for peripheral angiography. The authors observed no difference in contrast-induced nephropathy or the composite endpoint (death, renal replacement therapy, or progressive kidney failure) between the hydration options.

Take Home Pearls: Sodium bicarbonate for hydration after coronary angiography appears to reduce mortality risks when compared with saline.