Intravenous N-acetylcysteine for preventing contrast-induced nephropathy: A randomised trial

详细信息    查看全文

• 作者：Nieves Carbonell ; Marisa Blasco ; Rafael Sanjuá ; n ; Esther Pé ; rez-Sancho ; Juan Sanchis ; Luis Insa ; Vicente Bodí ; Julio Nú ; ñ ; ez ; Rafael Garcí ; a-Ramó ; n ; Alfonso Miguel
• 关键词：N-Acetylcysteine ; Contrast-induced nephropathy ; Coronary angiography
• 刊名：International Journal of Cardiology
• 出版年：2007
• 出版时间：31 January 2007
• 年：2007
• 卷：115
• 期：1
• 页码：57-62
• 全文大小：268 K

文摘

>Background

Studies evaluating the role of N-acetylcysteine in patients undergoing coronary angiography have yielded inconsistent data. Less is known about patients with normal renal function at baseline.

Methods

Prospective, double-blind, placebo-controlled trial to determine the benefits of intravenous N-acetylcysteine as an adjunct to hydration in this kind of population. Patients were randomly assigned to receive either N-acetylcysteine (600 mg twice daily) or placebo, in addition to 0.45 % intravenous saline. The primary end point was development of contrast-induced nephropathy, defined as an acute increase in the serum creatinine concentration ≥ 0.5 mg/dl and/or > 25 % increase above baseline level at 48 h after contrast dosing.

Results

A total of 216 patients were studied: N-acetylcysteine = 107 and placebo = 109. Treatment groups were similar with respect to baseline clinical characteristics. Overall incidence of contrast-induced nephropathy was 10.2 % , 10.3 % in the N-acetylcysteine group and 10.1 % in the placebo group. Furthermore, no significant differences were observed when considering the non-diabetic population, although there was a trend towards a protective effect of N-acetylcysteine in the subgroup of 47 patients with both hypertension and diabetes. There were no significant changes in serum urea nitrogen concentrations. The incidence of in-hospital adverse clinical events was low: no patient with contrast-induced nephropathy required dialysis, the median Coronary Unit stay was 4.5 vs. 4 days, and the mortality rate was 2.8 % vs. 4.6 % in the N-acetylcysteine and placebo groups, respectively (p = NS).

Conclusions

The prophylactic administration of intravenous N-acetylcysteine provides no additional benefit to saline hydration in high-risk coronary patients with normal renal function.