title: Interactions between serum creatinine, volume status, N-acetylcysteine, and contrast-induced nephropathy.
abstract: Contrast-induced nephropathy is reported to be the third leading cause of acute renal failure. The development of contrast-induced nephropathy is associated with prolonged hospitalization, the potential need for renal replacement therapy, and increased mortality. N-acetylcysteine is commonly used for the prevention of contrast-induced nephropathy despite inconsistent results from numerous clinical trials and meta-analyses. The advantage of N-acetylcysteine in most studies was based on a decrease in the serum creatinine concentration and a decrease in oxidative stress. N-acetylcysteine itself can directly lower serum creatinine concentration without improving renal function, and hypovolemia can affect the oxidative stress. In most of the N-acetylcysteine studies, there are a lack of volume status and secondary end points. The value of N-acetylcysteine for the prevention of contrast-induced nephropathy seems questionable. The interactions between serum creatinine, N-Acetylcysteine, volume status, and the development of contrast-induced nephropathy were discussed in this letter.
authors.forename: Omer
authors.initials: O
authors.lastname: Toprak
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D001810:Blood Volume; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D003287:Contrast Media; D003404:Creatinine; D000111:Acetylcysteine