title: MESNA (sodium 2-mercaptoethanesulfonate) for prevention of contrast medium-induced nephrotoxicity - controlled trial.
abstract: BACKGROUND
  The purpose of this study was to examine the efficacy of sodium 2-mercaptoethanesulfonate (MESNA), a reactive oxygen scavenger, in at-risk patients given radiographic contrast agents. Contrast-induced nephropathy (CIN) is a common complication of radiographic procedures; reactive oxygen species (ROS) could play a key role.
  
  
  METHODS
  We conducted a randomized, double-blinded, placebo-controlled trial in 100 patients with stable serum creatinine levels ≥ 150 µmol/l. They received an infusion of either 1,600 mg of MESNA (n = 51) or placebo (n = 49) plus 0.9% saline prior to and after contrast administration. CIN was defined as a ≥ 25% increase in serum creatinine after 48 h compared to baseline.
  
  
  RESULTS
  CIN occurred in 7 patients in the placebo group and none in the MESNA group (p = 0.005). The adjusted odds ratio for CIN was 0.17 (95% confidence interval 0.03 - 0.80, p = 0.026) in the MESNA group compared to the placebo group. Cystatin C concentrations decreased slightly in the MESNA group but increased in the control group (p < 0.05).
  
  
  CONCLUSIONS
  MESNA plus volume expansion before and during contrast exposure was effective in this single-center study for preventing CIN compared to volume expansion alone.
authors.affiliation: Nephrology Division, Clinic for Internal Medicine I, Center of Internal Medicine, University Hospital Ulm, Ulm, Germany. ulla.ludwig@uniklinik-ulm.de
authors.forename: U
authors.initials: U
authors.lastname: Ludwig
authors.forename: M K
authors.initials: MK
authors.lastname: Riedel
authors.forename: M
authors.initials: M
authors.lastname: Backes
authors.forename: A
authors.initials: A
authors.lastname: Imhof
authors.forename: R
authors.initials: R
authors.lastname: Muche
authors.forename: F
authors.initials: F
authors.lastname: Keller
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D007677:Kidney Function Tests; D008297:Male; D015080:Mesna / Q000627:therapeutic use*; D008875:Middle Aged; D010919:Placebos; D020011:Protective Agents / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media; D010919:Placebos; D020011:Protective Agents; D015080:Mesna