[New usage for an old drug: acetylcysteine for contrast-induced nephropathy].
Contrast induced nephropathy is the third common cause of hospital-acquired renal failure. The pathophysiology and the mechanism involved in the contrast media induced renal failure are not well understood but it is thought to be the result of direct renal toxicity and medullary ischemia. The only preventive measure proven to reduce such nephropathy is hydration (pre- and post-procedure). However, the above treatment is partially effective. The antioxidant N-acetylcysteine has recently been studied for the prevention of contrast induced nephropathy in several prospective, randomized, placebo-controlled studies among patients with moderate renal insufficiency. Although some discrepancies exist, N-acetylcysteine appears to reduce the risk of contrast-induced nephropathy. N-acetylcysteine has a safety profile and low cost. Taken together, N-acetylcysteine is recommended for the prevention of contrast-induced nephropathy in high-risk patients.
Asher
Ilan
I
Internal Medicine B Department, Kaplan Medical Center, Rehovot, Israel. ilan@kv-yavne.co.il
Hammerman
Ariel
A
Sthoeger
Zev
Z
D000111:Acetylcysteine / Q000627:therapeutic use*; D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D051437:Renal Insufficiency / Q000139:chemically induced / Q000188:drug therapy* / Q000517:prevention & control
D003287:Contrast Media; D000111:Acetylcysteine