Purpose: The aim of our study was to evaluate renal function assessed by serum creatinine as well as novel biomarkers in 142 patients with stable coronary heart disease and normal serum creatinine undergoing percutaneous coronary interventions (PCI) depending on the type of hydration: physiological saline vs. sodium bicarbonate (1:1 randomization).
Materials and methods: Serum and urinary NGAL were evaluated before and after 8-12, and 24 hours after PCI. Serum cystatin C, serum creatinine, estimated glomerular filtration rate using different formulae were assessed before PCI, and 24 hours after the procedure.
Results: Only 2 patients (2.8%) from the saline-hydrated group fulfilled the criteria for CI-AKI. In patients hydrated with sodium bicarbonate serum creatinine declined significantly (p<0.01). In patients hydrated with sodium bicarbonate a significant fall in serum NGAL after 8-12 hours was found. In sodium bicarbonate group cystatin C decreased non significantly after 8-12 hours, then returned to the baseline values. In patients hydrated with physiological saline serum NGAL before PCI and after 24 hours correlated positively with cystatin C and eGFR by CKD-EPI. In patients hydrated with sodium bicarbonate baseline serum NGAL correlated with NGAL baseline cystatin C and eGFR by CKD-EPI, similarly serum NGAL after 24 hours correlated with cystatin C.
Conclusion: We suggest to rather use sodium bicarbonate in a hydration protocol in patients undergoing PCI. However, the value of NGAL in this setting remains to be elucidated and volume expansion remain the unquestionable prevention methods of CI-AKI.