Prevention of contrast-induced nephropathy: the rational use of sodium bicarbonate.

The incidence of contrast-induced nephropathy (CIN) is increasing due to the growing number of patients undergoing radiocontrast studies. CIN is associated with a mortality rate as high as 34%. The purpose of this article is to review the strategies for preventing CIN and explore the role of sodium bicarbonate in this setting. A review of current literature suggests that prophylactic N-acetylcysteine and hydration with sodium bicarbonate may be the best pharmacological approach to preventing CIN. This article provides the dosing, administration, and monitoring guidelines for sodium bicarbonate, as well as implications for the nephrology nurse.