Abstract
Radiocontrast nephropathy (RCN) is one of the most common etiologies of hospital-acquired acute kidney injury (AKI),accounting for more than 10% of cases. There have been conflicting reports on the use of intravenous administration of sodiumbicarbonate and oral N-acetylcysteine (NAC) for prevention of RCN. In this issue of the Journal, Koo et al compare the efficacy ofsodium bicarbonate hydration with sodium chloride solution. They concluded that the efficacy of sodium bicarbonate hydration inthe prevention of RCN seemed comparable to that of sodium chloride hydration. Oral NAC is safe and inexpensive. Therefore, wecan propose that sodium bicarbonate or sodium chloride hydration with oral NAC in the prevention of RCN is probably effective,especially in CKD patients undergoing coronary procedure. However, additional large, multicenter, randomized, controlled trialswill be required to define the true role of sodium bicarbonate and NAC in preventing RCN.