A study investigated GPCR Compound Library whether oral intake of sodium chloride and water exerts effects similar to that of intravenous saline hydration [108]. In this RCT of saline hydration to prevent CIN in 312 patients with CKD (mean CCr 37 mL/min/1.73 m2), patients were randomly assigned to 4 arms. In the first group, 76 patients received 1 g/10 kg of body weight per day of sodium chloride orally for 2 days before the procedure, and in the second group, 77 patients received 0.9 % saline intravenously at a rate of 15 mL/kg for 6 h before the procedure. The incidence of CIN was 6.6 % in

the first group and 5.2 % in the second group (NS). The authors concluded that oral saline hydration was as effective as intravenous saline hydration for the prevention of CIN. Although reports have indicated that oral hydration and intravenous saline infusion are similar in terms of the prevention of CIN, there

is no conclusive evidence supporting the efficacy of oral hydration at this time. Oral hydration with water cannot be recommended as an alternative to intravenous infusion of physiological saline. Further studies are needed to confirm whether CIN can be prevented by oral water intake prior to the procedure and intravenous hydration after the procedure in patients in whom preprocedural intravenous hydration is not feasible. There is no conclusive evidence regarding Ulixertinib supplier the equivalence of oral saline hydration and intravenous saline

hydration in the prevention of CIN. Although oral hydration is inferior to intravenous hydration as a measure to prevent CIN, oral hydration prior to contrast 2-hydroxyphytanoyl-CoA lyase exposure is recommended as a measure to treat dehydration and prevent discomfort caused by contrast media. Does sodium bicarbonate-based hydration decrease the risk for developing CIN? Answer: Although sodium bicarbonate-based hydration may decrease the risk for developing CIN and be superior in this regard to saline hydration, currently available evidence does not support the conclusion that sodium bicarbonate-based hydration is essential in the prevention of CIN. The efficacy of sodium bicarbonate-based hydration in the prevention of CIN has been evaluated by using MEYLON® (1 Eq/L) at a volume of 20 mL and those using 154 mEq/L of sodium bicarbonate solution. In Japan, 1.26 % Sodium Bicarbonate Injection (Fuso) (152 mEq/L) is commercially available. Seven meta-analyses have been published on the comparison of sodium bicarbonate-based hydration with saline hydration in the prevention of CIN, and all but 1 analysis concluded that sodium bicarbonate-based hydration was superior to saline hydration in reducing the risk of CIN [109–115]. In 2009, Zoungas et al. [109] searched data published from 1950 to 2008, and reviewed 23 published and unpublished RCTs of intravenous sodium bicarbonate (9 peer-reviewed studies and 14 abstracts) with information on 3,563 patients.