Should acetylcysteine be used to prevent contrast induced nephropathy?
Diagnostic and therapeutic procedures that require the infusion of iodine containing contrast solutions are associated with the risk of contrast-induced nephropathy, a condition that can cause significant morbidity. Acetylcysteine has been proposed as a measure to prevent this condition. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified 20 systematic reviews including 64 randomized trials. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded that even though acetylcysteine might not cause important adverse effects, it does not decrease need for dialysis, mortality or other important outcomes.
Servicio de Clínica Médica, Hospital Alemán, Buenos Aires, Argentina; Programa de Medicina Basada en Pruebas, Hospital Alemán, Buenos Aires, Argentina. Address: Facultad de Medicina, Pontificia Universidad Católica de Chile, Lira 63, Santiago Centro, Chile. Email: radagabriel@epistemonikos.org.
Ariel
A
Izcovich
Gabriel
G
Rada
D000111:Acetylcysteine / Q000627:therapeutic use*; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007455:Iodine / Q000008:administration & dosage / Q000009:adverse effects; D007674:Kidney Diseases / Q000139:chemically induced / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic
D003287:Contrast Media; D007455:Iodine; D000111:Acetylcysteine