N-acetylcysteine use to prevent contrast medium-induced nephropathy: premature phase III trials.
To date there has been no general consensus regarding the effectiveness of N-acetylcysteine as a protective therapy against contrast medium-induced nephropathy. Several phase III clinical trials have been conducted without a proper understanding of N-acetylcysteine pharmacology, particularly with regard to first-pass hepatic metabolism. A review was conducted of the literature concerning contrast medium-induced nephropathy and new studies of human N-acetylcysteine pharmacology were performed. After an analysis was performed, it was concluded that further phase I and phase II trials are needed. The efficacy of N-acetylcysteine in the prevention of contrast medium-induced nephropathy may be demonstrated with the use of higher doses than used in earlier studies, in combination with parenteral administration.
Stenstrom
David A
DA
Department of Neurology, Oregon Health & Science University, Portland, Oregon 97239, USA.
Muldoon
Leslie L
LL
Armijo-Medina
Hector
H
Watnick
Suzanne
S
Doolittle
Nancy D
ND
Kaufman
John A
JA
Peterson
Darryl R
DR
Bubalo
Joseph
J
Neuwelt
Edward A
EA
D000111:Acetylcysteine / Q000494:pharmacology / Q000627:therapeutic use* / Q000633:toxicity; D017326:Clinical Trials, Phase III as Topic; D003287:Contrast Media / Q000009:adverse effects*; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*
D003287:Contrast Media; D000111:Acetylcysteine