Contrast-induced nephropathy: N-acetylcysteine for prevention
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2006 Jun 29;354(26):2773-82 Randomized Controlled Trial, Multicenter Study
IN renal toxic damage, radiologic contrast The Use of
high dose acetylcysteine (1200 mg IV, then 1200 mg orally/12h for 2 days)
As Treatment, Acute
Is better Than
standard dose acetylcysteine (600 mg IV, then 600 mg orally/12h for 2 days) or placebo
To prevent acute increases in creatinine following primary angioplasty: 8% double dose VS 15% standard dose VS 33% placebo. And to reduce in-hospital mortality: 3% double dose VS 4% standard dose VS 11% placebo
Heart. 2005 Jun;91(6):774-8 Randomized Controlled Trial
IN renal toxic damage, radiologic contrast, low to moderate risk patients The Use of
acetylcysteine
As Treatment, Acute
Is equal Than
placebo
To prevent increase of serum cretinine with contrast agent when having a coronary angiography or procedure: about 10% both groups
Circulation. 2011 Sep 13;124(11):1250-9 Randomized Controlled Trial, Multicenter Study
IN renal toxic damage, radiologic contrast, moderate to high risk patients The Use of
acetylcysteine 1200 mg, orally twice daily for 2 doses before and 2 doses after the procedure
As Treatment, Acute
Is equal Than
placebo
To modufy the incidence of contrast-induced acute kidney injury: 12.7% for both treatment and placebo
N Engl J Med. 2017 Nov 12. doi: 10.1056/NEJMoa1710933. [Epub ahead of print] Randomized Controlled Trial, Multicenter Study
IN renal toxic damage, radiologic contrast,high risk patients The Use of
IV 1.26% sodium bicarbonate and/or 5 days of oral acetylcysteine
As Treatment, Acute
Is equal Than
IV 0.9% sodium chloride and/or placebo
To modify at 3 months a composite of death, need for dialysis, or a persistent 50% creatinine increase from baseline: 4% bicarbonate, 5% saline, 5% acetylcysteine, 5% placebo.