title: N-acetylcysteine use to prevent contrast medium-induced nephropathy: premature phase III trials.
abstract: 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.
authors.affiliation: Department of Neurology, Oregon Health & Science University, Portland, Oregon 97239, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Stenstrom
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Muldoon
authors.forename: Hector
authors.initials: H
authors.lastname: Armijo-Medina
authors.forename: Suzanne
authors.initials: S
authors.lastname: Watnick
authors.forename: Nancy D
authors.initials: ND
authors.lastname: Doolittle
authors.forename: John A
authors.initials: JA
authors.lastname: Kaufman
authors.forename: Darryl R
authors.initials: DR
authors.lastname: Peterson
authors.forename: Joseph
authors.initials: J
authors.lastname: Bubalo
authors.forename: Edward A
authors.initials: EA
authors.lastname: Neuwelt
mesh_terms: 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*
chemical_list: D003287:Contrast Media; D000111:Acetylcysteine