Renoprotective effect of high periprocedural doses of oral N-acetylcysteine in patients scheduled to undergo a same-day angiography.
BACKGROUND
Few studies that have assessed the effect of abbreviated oral N-acetylcysteine (NAC) regimens in radiocontrast-induced nephropathy (RCIN) yield mixed results.


OBJECTIVE
To evaluate the renoprotective effect of high periprocedural oral doses (HPOD) of NAC in patients with chronic renal impairment undergoing a same-day angiography.


METHODS
Sixty one patients with renal impaired function scheduled to undergo a same-day angiography were randomly assigned to NAC 1200 mg orally 3 hours before and 3 after the procedure, or a placebo. All patients received 0.9% saline intravenous. RCIN was defined as an increase in SCC > 0.5 mg/dl 48 hours after the procedure.


RESULTS
The mean baseline SCC for all patients was 1.44 +/- 0.42 mg/dl. A significant difference in SCC change at 48 hours after the angiography was found (-0.07 mg/dl NAC, 0.09 mg/dl placebo, P = 0.04). RCIN occurred in 1 (3%) patient of NAC group and in 2 (7.1%) patients of placebo group (P = 0.59). Adverse effects were similar in both groups.


CONCLUSIONS
In patients with mild renal impairment patients undergoing angiographic procedures, HPOD of NAC were more effective than placebo in preventing SCC change 48 hours. A non significant benefit in RCIN incidence was found.
Balderramo
Domingo C
DC
Internal Medicine Department, Hospital Privado, Centro Medico de Córdoba, Córdoba, Argentina.
Verdu
Mariano Badra
MB
Ramacciotti
Constanza F
CF
Cremona
Luis S
LS
Lemos
Pablo A
PA
Orías
Marcelo
M
Eduardo
Moreyra
M
D000111:Acetylcysteine / Q000008:administration & dosage / Q000627:therapeutic use*; D000284:Administration, Oral; D000368:Aged; D000792:Angiography; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D003287:Contrast Media / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies
D000975:Antioxidants; D003287:Contrast Media; D000111:Acetylcysteine