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N-acetylcysteine does not prevent contrast induced nephropathy after cardiac catheterisation with an ionic low

V O Gomes1, C E Poli de Figueredo, P Caramori

  • 1Division of Interventional Cardiology, Hospital São Lucas, Pontifícia Universidade Católica-RS, Porto Alegre, Brazil.

Heart (British Cardiac Society)
|May 17, 2005
PubMed

Insights

Oral N-acetylcysteine did not prevent contrast-induced nephropathy (CIN) in patients undergoing cardiac procedures. This study found no significant difference in CIN rates between N-acetylcysteine and placebo groups.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Contrast-induced nephropathy (CIN) is a risk following cardiac catheterisation.
  • Patients with pre-existing renal risk factors or diabetes are particularly susceptible.
  • Ionic low osmolality contrast media are used in cardiac procedures.

Purpose of the Study:

  • To evaluate the efficacy of oral N-acetylcysteine in preventing CIN.
  • To assess N-acetylcysteine's role in low to moderate risk patients undergoing cardiac catheterisation.
  • To compare CIN incidence with and without N-acetylcysteine administration.

Main Methods:

  • A multicentre, double-blind, placebo-controlled clinical trial.
  • 156 patients with renal risk factors or diabetes were enrolled.
  • Patients received either oral N-acetylcysteine (600 mg twice daily for two days) or placebo.

Main Results:

  • No significant difference in CIN development between N-acetylcysteine and placebo groups (10.4% vs 10.1%, p=1.00).
  • Mean serum creatinine change was comparable in both groups.
  • No significant difference in endogenous creatinine clearance changes was observed.

Conclusions:

  • Oral N-acetylcysteine does not prevent CIN in low to moderate risk patients.
  • The study did not support the use of N-acetylcysteine for CIN prevention in this population.
  • Further research may be needed for different patient groups or contrast agents.
Abstract

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