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Role of N-Acetylcysteine to Prevent Contrast-Induced Nephropathy: A Meta-analysis

Rohit S Loomba1, Parinda H Shah, Saurabh Aggarwal

  • 11Children's Hospital of Wisconsin/Medical College of Wisconsin Affiliated Hospitals, Wauwatosa, WI; 2Advocate Illinois Masonic Medical Center, Chicago, IL; and 3James A. Lovell Federal Health Center/Chicago Medical School, North Chicago, IL.

American Journal of Therapeutics
|August 29, 2013
PubMed

Insights

N-acetylcysteine (NAC) may help prevent contrast-induced nephropathy in patients undergoing coronary angiography. However, NAC did not significantly improve creatinine levels, reduce dialysis needs, or lower mortality rates in this systematic review.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Contrast-induced nephropathy (CIN) is a significant risk following coronary angiography.
  • The efficacy of N-acetylcysteine (NAC) in preventing CIN remains debated due to varied study designs and outcomes.

Purpose of the Study:

  • To systematically evaluate the effectiveness of N-acetylcysteine (NAC) in preventing contrast-induced nephropathy (CIN).
  • To analyze the impact of NAC dosage and administration route on CIN prevention and clinical outcomes.

Main Methods:

  • A systematic literature search was conducted across PubMed, Ovid, and the Cochrane library.
  • Studies were pooled using strict inclusion/exclusion criteria.
  • Subgroup analyses were performed based on NAC dose (600 mg) and route (oral administration).

Main Results:

  • Pooled analysis indicated NAC significantly favored CIN prevention in patients undergoing coronary angiography.
  • No significant benefits were observed for NAC regarding pre/post-angiography creatinine levels, dialysis requirements, or all-cause mortality.
  • Subgroup analyses showed no significant differences in outcomes based on NAC dose or route, except for the incidence of postcatheterization nephropathy.

Conclusions:

  • N-acetylcysteine (NAC) may not significantly impact overall clinical outcomes after coronary or peripheral artery catheterization.
  • The dose and route of NAC administration do not appear to influence these clinical outcomes.
  • Further research may be needed to clarify the precise role of NAC in CIN prevention.

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