Efficacy of N-acetylcysteine and hydration versus placebo and hydration in decreasing contrast-induced renal dysfunction in patients undergoing coronary angiography with or without concomitant percutaneous coronary intervention

N-acetylcysteine does not prevent contrast-induced nephropathy after cardiac catheterization in patients with diabetes mellitus and chronic kidney disease: a randomized clinical trial

“…The main finding of the current study was that the prophylactic oral administration of NAC did not provide any benefit as compared with a placebo to reduce the incidence of CIN in patients with chronic kidney disease and diabetes mellitus, who are a high-risk population for the development of CIN. Our findings are consistent with those in studies reporting that NAC provides no benefit over hydration for the prevention of CIN [ 12 , 13 , 15 , 17 , 20 , 22 , 23 ]. In addition, our study supports and expands the studies by Coyle et al[ 26 ], Durham et al [ 17 ], and Gomes et al [ 9 , 24 ], who evaluated the efficacy of NAC in the prevention of CIN in diabetic patients.…”

Comparative Effectiveness of 12 Treatment Strategies for Preventing Contrast-Induced Acute Kidney Injury: A Systematic Review and Bayesian Network Meta-analysis

“…Another meta- 43 44 45 analysis found that a combination of NAC and sodium bicarbonate substantially 46 47 reduced CI-AKI risk compared with NAC alone. 55 However, we found that both 59 1 likelihood of a range of treatments to prevent CI-AKI, and reports the results of mixed 2 3 comparisons of multiple treatments that have been rarely compared in head to head 4 5 6 trials. We also report the ranking probability for all 12 treatment agents.…”

Gadolinium‐Based Coronary Angiography in Patients with Contraindication for Iodinated X‐Ray Contrast Medium: A Word of Caution

“…However, in a randomized trial, Seyon et al assessed the efficacy of N-acetylcysteine in decreasing the incidence of contrast-induced renal dysfunction, and found no difference in serum creatinine or creatinine clearance at 24 hours or at 48 hours after contrast agent exposition between the treatment and control groups. 17 With a gadolinium application between 15 and 45 mL per coronary angiography, dosages were clearly below this critical concentration of 0.4 mmol/kg. Compared to conventional iodinated contrast medium, gadolinium can be eliminated almost completely out of the human body by renal dialysis.…”

“…In all patients, renal function was assessed by determination of creatinine values in preprocedural and postprocedural blood samples, 6 and 24 hours after gadolinium application, corresponding to the publication of Seyon et al, who assessed the efficacy of N-acetylcysteine in decreasing the incidence of contrast-induced renal dysfunction after contrast agent exposition. 17 Furthermore, creatinine clearance was calculated by using the Cockcroft-Gault formula. Acute renal failure was defined as either an increase in serum creatinine of 0.5 mg/dL or 25% of baseline parameter or the need for dialysis.…”