1 - 3 The reported incidence of contrast-induced nephropathy ranges from 2% in low-risk populations to 50% in high-risk populations. It is a common cause of renal failure associated with prolonged hospitalization, increased health care costs, and substantial morbidity and mortality. Trial Registration Identifier: NCT00312117Ĭontrast medium–induced nephropathy is a recognized complication of exposure to iodine contrast media. In patients randomized to receive sodium bicarbonate vs sodium chloride, the rates of death, dialysis, myocardial infarction, and cerebrovascular events did not differ significantly at 30 days (1.7% vs 1.7%, 0.6% vs 1.1%, 0.6% vs 0%, and 0% vs 2.2%, respectively) or at 30 days to 6 months (0.6% vs 2.3%, 0.6% vs 1.1%, 0.6% vs 2.3%, and 0.6% vs 1.7%, respectively) ( P = .10 for all).Ĭonclusion The results of this study do not suggest that hydration with sodium bicarbonate is superior to hydration with sodium chloride for the prevention of contrast medium–induced nephropathy in patients with moderate to severe chronic kidney disease who are undergoing coronary angiography. The primary end point was met in 13.3% of the sodium bicarbonate group and 14.6% of the sodium chloride group (relative risk, 0.94 95% confidence interval, 0.55-1.60 P = .82). The groups were well matched for baseline characteristics. Results Median patient age was 71 (interquartile range, 65-76) years, and 45% had diabetes mellitus. Main Outcome Measure The primary end point was a 25% or greater decrease in the estimated glomerular filtration rate on days 1 through 4 after contrast exposure. Interventions Patients were randomized to receive either sodium chloride (n = 178) or sodium bicarbonate (n = 175) administered at the same rate (3 mL/kg for 1 hour before coronary angiography, decreased to 1.5 mL/kg per hour during the procedure and for 4 hours after the completion of the procedure). Included patients were 18 years or older and had an estimated glomerular filtration rate of 60 mL/min per 1.73 m 2 or less and 1 or more of diabetes mellitus, history of congestive heart failure, hypertension, or age older than 75 years. Objective To determine if sodium bicarbonate is superior to sodium chloride for preventing contrast medium–induced nephropathy in patients with moderate to severe chronic kidney dysfunction who are undergoing coronary angiography.ĭesign, Setting, and Patients Randomized, controlled, single-blind study conducted between January 2, 2006, and January 31, 2007, and enrolling 353 patients with stable renal disease who were undergoing coronary angiography at a single US center. Shared Decision Making and CommunicationĬontext Sodium bicarbonate has been suggested as a possible strategy for prevention of contrast medium–induced nephropathy, a common cause of renal failure associated with prolonged hospitalization, increased health care costs, and substantial morbidity and mortality.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography. ![]() However, using only one lane doesn’t increase the maximum speed - it just means that car (data packet) doesn’t have as much competition in the journey from point A to point B. ![]() Just like a highway, there’s a point at which the amount of cars will cause a traffic jam or slowdown due to congestion. Bandwidth vs Speed: The Highway MetaphorĪnother common way of describing the difference between bandwidth and speed is the “highway metaphor.” Essentially, you can imagine bandwidth as the number of lanes on the highway, and speed as the speed limit on each lane in the highway. Speed is more accurately called “throughput,” meaning the rate at which data is “put through” to your laptop/phone/etc. Speed, meanwhile, is the amount of Megabits per second that can be downloaded by a given device using your home network. ![]() Bandwidth is the width of that pipe - essentially, the maximum volume of water (data) that can pass through at once. ![]() Think of it this way: data is traveling over the Internet cable like water in a pipe. Speed: the rate at which data can be downloaded (or uploaded) to a given device using that Internet connection, also measured in Megabits per second.īandwidth vs Speed: The Plumbing Metaphor.Bandwidth: the maximum amount of data that can be transmitted over an Internet connection, as measured in Megabits per second (Mbps).In fact, there is a subtle difference between them. Internet providers frequently use the terms “bandwidth” and “speed” interchangeably. Bandwidth Calculator Tool Bandwidth vs speed: what’s the difference?
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