Low urine pH: a new marker for contrast-associated acute kidney injury?

Intravenous hydration is the standard of care for preventing contrast-associated acute kidney injury (CA-AKI) in patients undergoing invasive cardiovascular procedures12. However, the type of solution, the volume and the timing of administration are still a matter of debate. Intravascular volume expansion is usually accomplished by the administration of isotonic saline. Several hydration protocols have been reported and recommended (Table 1).



Sodium bicarbonate has been proposed as an alternative solution to prevent CA-AKI3. One potential mechanism of kidney protection is the alkalinisation of the renal tubular fluid and the scavenging of reactive species generated from nitric oxide. Free radical formation ...