R.E.B.E.L.EM - April 9, 2020 - By Salim Rezaie
"Paper: Tirnal RJ et al. Effect of No Prehydration vs Sodium Bicarbonate Prehydration Prior to Contrast-Enhanced Computed Tomography in the Prevention of Postcontrast Acute Kindey Injury in Adults with Chronic Kidney Disease: The Kompas Randomized Clinical Trial. JAMA Intern Med 2020. PMID: 32065601
Author Conclusion: “Among patients with stage 3 CKD undergoing contrast-enhanced computed tomography, withholding prehydration did not compromise patient safety. The findings of this study support the option of not giving prehydration a safe and cost-efficient measure.”
Clinical Take Home Point: There is no benefit of fluid expansion with sodium bicarbonate prehydration vs no prehydration in patients with stage 3 CKD requiring elective IV contrast enhanced CTs. In addition, prehydration is accompanied with significant health care costs and although not shown in this trial could potentially increase adverse effects."