Acetylcysteine for the prevention of radiocontrast -induced nephropathy.
Radiocontrast-induced nephropathy is the 3rd most common cause of in-hospital acute renal failure after hypotension and surgery. Radio-graphic contrast media are used at a progressive rate for several diagnostic and therapeutic applications. Prevention of radiocontrast-induced nephropathy will become more important, including risk of patient impairment and costs. Radiocontrast-induced ne-phropathy is due to vasoconstriction-mediated renal medullary ischemia and direct toxic damage to renal tubular epithelial cells. These effects may in part be mediated by generation of reactive oxygen species. Several prospective, randomized, placebo-controlled studies in patients with moderate renal insufficiency showed that the prophylactic oral administration of acetylcysteine at a dose of 600 mg twice daily along with hydration prevents the reduction in renal function after radiocontrast administration. Recently, intravenous administration of acetyl-cysteine has also been shown to be effective. Use of acetylcysteine together with hydration is the treatment of choice to prevent radiocontrast-induced nephropathy.
Tepel
M
M
Department of Medicine IV, Campus Benjamin Franklin, Charite, University of Berlin, Berlin, Germany. Tepel@zedat.fu-berlin.de
D000111:Acetylcysteine / Q000627:therapeutic use*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology* / Q000517:prevention & control*; D003287:Contrast Media / Q000009:adverse effects*; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans
D003287:Contrast Media; D016166:Free Radical Scavengers; D000111:Acetylcysteine