N-acetylcysteine for Prevention of Contrast-Induced Nephropathy: A Narrative Review

Area of Science:

• Nephrology
• Radiology
• Pharmacology

Background:

• Contrast-induced nephropathy (CIN) increases patient morbidity, mortality, hospital stay, and costs.
• Preventative strategies for CIN are crucial, especially in at-risk populations.
• Adequate hydration is the only consistently effective preventive measure for CIN.

Purpose of the Study:

• To review the current evidence on N-acetylcysteine (NAC) for preventing CIN.
• To evaluate the effectiveness and limitations of NAC in renal protection during contrast media procedures.

Main Methods:

• Systematic review of studies investigating NAC for CIN prevention.
• Analysis of clinical trials and observational studies on NAC's nephroprotective effects.
• Examination of proposed mechanisms of action for NAC, including antioxidant and vasodilatory properties.

Main Results:

• N-acetylcysteine (NAC) has been widely investigated for CIN prevention since 2000.
• Findings regarding NAC's nephroprotective capabilities in patients undergoing contrast procedures are conflicting.
• There is a lack of definitive evidence supporting the effectiveness of NAC in preventing CIN.

Conclusions:

• The efficacy of N-acetylcysteine (NAC) in preventing contrast-induced nephropathy remains uncertain.
• While antioxidant and vasodilatory mechanisms are proposed, definitive proof of NAC's benefit is lacking.
• Further rigorous research is required to establish the role of NAC in CIN prevention.