Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury (AKI) and associated adverse outcomes after angiography without definitive evidence of their efficacy. Among patients at high risk for renal complications who were undergoing angiography, there was no benefit of intravenous sodium bicarbonate over intravenous sodium chloride or of oral acetylcysteine over placebo for the prevention of death, need for dialysis, or persistent decline in kidney function at 90 days or for the prevention of contrast-associated acute kidney injury.

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