Effects of N-Acetylcysteine on Renal Hemodynamics in Contrast Media-Induced Nephropathy

Abstract

Background: N-acetylcysteine (NAC) has been proposed to prevent radiocontrast nephropathy in high-risk patients. Methods: The effect of single-dose and prolonged administration of NAC before application of either the ionic, high-osmolar radiocontrast agent diatrizoate sodium (DTZ) or the nonionic, low-osmolar radiocontrast agent iohexol (IOH) in a rat model combining uninephrectomy, salt depletion, and administration of indomethacin was explored. Arterial blood pressure and total, cortical, and medullary blood flow were continuously recorded in anesthetized Sprague-Dawley rats. Results: NAC had no effect on renal hemodynamics in control rats. Both DTZ and IOH induced biphasic changes in renal blood flow and cortical renal blood flux and persistently reduced medullary blood flux. Neither single-dose nor prolonged administration of NAC prevented the hemodynamic changes following administration of DTZ or IOH, respectively. Acute prophylactic administration of NAC prevented increased urinary ET excretion after injection of IOH and, to a smaller degree, of DTZ. Both an ionic, high-osmolar (DTZ) and a nonionic, low-osmolar (IOH) radiocontrast agent induce marked changes in renal hemodynamics in salt-depleted rats treated with indomethacin. Conclusions: Renal perfusion is not affected by NAC application in a model of experimental contrast nephropathy in rats. Other effects of NAC might thus account for the presumed renoprotective properties.

Novel Nanoliposomes Alleviate Contrast-Induced Nephropathy by Mediating Apoptosis Response in New Zealand Rabbits

“…Optical and electron microscopy examination of renal tissue in the contrast group showed severe damage, with vacuolar degeneration of renal tubular epithelial cells, nuclear pyknosis and lysis, mitochondrial swelling in renal tubular epithelial cells and disorder of the marginal ridge structure. The results of our study are basically consistent with those reported by others at home and abroad ( Krzossok et al, 2011 ; Ozkan et al, 2012 ; Gong et al, 2013 ). Compared with the contrast group, the degree of renal injury in the nano liposome and hydration groups was significantly reduced, but the degree of renal injury in the nano liposome group was clearly less, indicating that nano liposome administration works better than hydration.…”

Impact of an Early Decrease in Systolic Blood Pressure on The Risk of Contrast-Induced Nephropathy after Percutaneous Coronary Intervention

“…The early postprocedural period was thought to be the rush hour of contrast media excretion, causing rapid and prolonged renal hypoperfusion [4,5], which was the critical time window for CIN. Therefore, the decrease in blood pressure in the early phase after PCI may affect the development of CIN.…”