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N-acetylcysteine use to prevent contrast medium-induced nephropathy: premature phase III trials
David A Stenstrom1, Leslie L Muldoon, Hector Armijo-Medina
1Department of Neurology, Oregon Health & Science University, Portland, Oregon 97239, USA.
Abstract:
To date there has been no general consensus regarding the effectiveness of N-acetylcysteine as a protective therapy against contrast medium-induced nephropathy. Several phase III clinical trials have been conducted without a proper understanding of N-acetylcysteine pharmacology, particularly with regard to first-pass hepatic metabolism. A review was conducted of the literature concerning contrast medium-induced nephropathy and new studies of human N-acetylcysteine pharmacology were performed. After an analysis was performed, it was concluded that further phase I and phase II trials are needed. The efficacy of N-acetylcysteine in the prevention of contrast medium-induced nephropathy may be demonstrated with the use of higher doses than used in earlier studies, in combination with parenteral administration.
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