Does oral N-acetylcysteine reduce contrast-induced renal injury in patients with peripheral arterial disease undergoing peripheral angiography? A randomized-controlled study.
The nephroprotective role of N-acetylcysteine (NAC) against contrast-induced nephropathy (CIN) in patients undergoing peripheral arterial angiography remains unclear. A total of 40 patients undergoing peripheral arterial angiography were randomized to receive intravenous (iv) hydration only (group 1) or oral NAC in addition to iv hydration (group 2; ISRCTN: 35882618). Primary outcome was reduction in the elevation of urinary retinol binding protein (RBP), albumin-creatinine ratio (ACR), and serum creatinine (serC). Groups 1 and 2 had equivocal percentage reduction in RBP and ACR levels from baseline (P = .80 and .30). A significant reduction in serC was, however, observed with NAC by third postprocedure day (P = .04). One patient in the treatment arm developed CIN compared with 3 patients in the control group (P = .33). Equivocal changes in RBP and ACR levels by both treatments seem to indicate that either is equally effective in affording renal protection.
Sadat
Umar
U
Cambridge Vascular Unit, Addenbrooke's Hospital, Cambridge, UK. us229@cam.ac.uk
Walsh
Stewart R
SR
Norden
Anthony G
AG
Gillard
Jonathan H
JH
Boyle
Jonathan R
JR
D000111:Acetylcysteine / Q000494:pharmacology*; D000368:Aged; D000419:Albuminuria / Q000209:etiology; D000792:Angiography; D015415:Biomarkers / Q000097:blood / Q000652:urine; D003287:Contrast Media / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood / Q000652:urine; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D008297:Male; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging*; D054840:Retinol-Binding Proteins, Cellular / Q000652:urine; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D015415:Biomarkers; D003287:Contrast Media; D054840:Retinol-Binding Proteins, Cellular; D003404:Creatinine; D000111:Acetylcysteine