N-acetylcysteine does not prevent contrast induced nephropathy after cardiac catheterisation with an ionic low osmolality contrast medium: a multicentre clinical trial
Open Access
- 1 June 2005
- Vol. 91 (6), 774-778
- https://doi.org/10.1136/hrt.2004.039636
Abstract
To evaluate oral N-acetylcysteine in the prevention of contrast induced nephropathy (CIN) in patients at low to moderate risk undergoing cardiac catheterisation with ionic low osmolality contrast medium. In a multicentre double blind clinical trial 156 patients undergoing coronary angiography or percutaneous coronary intervention with serum creatinine > or = 106.08 micromol/l or creatinine clearance < 50 ml/min or diabetes mellitus were randomly assigned to receive N-acetylcysteine 600 mg orally twice daily for two days or placebo. Only low osmolality ionic contrast medium was used. Sixteen patients developed CIN, defined as an increase of 44.2 micromol/l in creatinine in 48 hours: eight of 77 patients (10.4%) in the N-acetylcysteine group and eight of 79 patients (10.1%) in the placebo group (p = 1.00). The mean (SD) change in serum creatinine was similar in both groups: 7.96 (35.36) micromol/l in the N-acetylcysteine group and 6.19 (25.64) micromol/l in the placebo group (p = 0.67). No difference was observed in the change in endogenous creatinine clearance (-0.54 (10.4) ml/min v -2.52 (12.3) ml/min, N-acetylcysteine and placebo, respectively, p = 0.28). Oral N-acetylcysteine did not prevent CIN in patients at low to moderate risk undergoing cardiac catheterisation with ionic low osmolality contrast medium.Keywords
This publication has 25 references indexed in Scilit:
- Prospective randomized study of N‐acetylcysteine, fenoldopam, and saline for prevention of radiocontrast‐induced nephropathyCatheterization and Cardiovascular Interventions, 2002
- Acetylcysteine protects against acute renal damage in patients with abnormal renal function undergoing a coronary procedureJournal of the American College of Cardiology, 2002
- Effects of Two Dimeric Iodinated Contrast Media on Renal Medullary Blood Perfusion and Oxygenation in DogsInvestigative Radiology, 2002
- Acetylcysteine and contrast agent-associated nephrotoxicityJournal of the American College of Cardiology, 2002
- Incidence and Prognostic Importance of Acute Renal Failure After Percutaneous Coronary InterventionCirculation, 2002
- Acetylcysteine to prevent angiography-related renal tissue injury (the APART trial)The American Journal of Cardiology, 2002
- Ultrastructural evaluation of the effects of the contrast media on the rat kidney.2001
- Prevention of Radiographic-Contrast-Agent–Induced Reductions in Renal Function by AcetylcysteineNew England Journal of Medicine, 2000
- A comparison of ionic versus nonionic contrast medium during primary percutaneous transluminal coronary angioplasty for acute myocardial infarction (GUSTO IIb)The American Journal of Cardiology, 2000
- Acute Renal Failure After Coronary InterventionAmerican Journal Of Medicine, 1997