N-Acetylcysteine In The Prevention Of Radiocontrast-Induced Nephropathy

Fishbane, Steven; Durham, John H.; Marzo, Kevin; Rudnick, Michael R.

doi:10.1097/01.asn.0000107562.68920.92

Cited by 177 publications

(139 citation statements)

References 102 publications

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“…Without adequate power, both false-positive and -negative results may be reported, thus confusing rather than informing clinical practice. N-acetylcysteine (NAC) for the prevention of contrast-induced AKI may be the most notorious example where the reporting of underpowered studies showing either a beneficial or no treatment effect has led to uncertainty regarding its use, despite the conduct of numerous clinical trials (21).…”

Section: Discussionmentioning

confidence: 99%

Ongoing Clinical Trials in AKI

Faubel

Chawla

Chertow

et al. 2012

Clinical Journal of the American Society of Nephrology

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SummaryAKI is an important public health issue. AKI is a common hospital complication associated with increased inhospital and long-term mortality, extensive morbidity (including prolonged hospital length of stay), and an estimated annual cost of at least $10 billion in the United States. At present, no specific therapy has been developed to prevent AKI, hasten recovery of kidney function, or abrogate the deleterious systemic effects of AKI. However, recent progress includes establishing a consensus definition of AKI and discovery of novel biomarkers that may allow early detection of AKI. Furthermore, significant insights into the pathophysiology of AKI and its deleterious systemic effects have been gleaned from animal studies. Urgently needed are large, definitive randomized clinical trials testing interventions to prevent and/or treat AKI. This review summarizes and analyzes current ongoing clinical trials registered with clinicaltrials.gov that address prevention or management of AKI. The purpose of this review is to provide a resource for people interested in potential prophylactic and therapeutic approaches to patient care and investigators hoping to plan and execute the next round of randomized clinical trials. Finally, this review discusses research needs that are not addressed by the current clinical trials portfolio and suggests key areas for future research in AKI.

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Section: Discussionmentioning

confidence: 99%

Ongoing Clinical Trials in AKI

Faubel

Chawla

Chertow

et al. 2012

Clinical Journal of the American Society of Nephrology

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“…N-acetylcysteine may show the greatest benefit when used in patients with severe preexisting renal dysfunction. 70,71 Furthermore, N-acetylcysteine has a relatively safe toxicity profile. Because its use is unlikely to cause harm and may provide protection against contrast-induced nephropathy, N-acetylcysteine could be considered.…”

mentioning

confidence: 99%

Clinical Pharmacology, Uses, and Adverse Reactions of Iodinated Contrast Agents: A Primer for the Non-radiologist

Pasternak

Williamson

2012

Mayo Clinic Proceedings

157

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Iodinated contrast agents have been in use since the 1950s to facilitate radiographic imaging modalities. Physicians in almost all specialties will either administer these agents or care for patients who have received these drugs. Different iodinated contrast agents vary greatly in their properties, uses, and toxic effects. Therefore, clinicians should be at least superficially familiar with the clinical pharmacology, administration, risks, and adverse effects associated with iodinated contrast agents. This primer offers the non-radiologist physician the opportunity to gain insight into the use of this class of drugs.

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“…[1][2][3][4] The incidence of CIN is low (1%-2%) in the general population; however, in high-risk patients, it has been calculated to be Ͼ20%-30%. [5][6][7] Several risk factors for CIN have been described, including CKD, diabetes mellitus, hypertension, older age, use of nephrotoxic medications, large contrast volume, dehydration, and repeated exposure to contrast agents (Ͻ72 hours). 1,[8][9][10][11] CIN has also been linked to length of hospital stay and increased hospital resource use.…”

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confidence: 99%

Prolonged Carotid Sinus Reflex Is a Risk Factor for Contrast-Induced Nephropathy following Carotid Artery Stenting

Kato¹,

Sakai²,

Tsujimoto³

et al. 2011

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Although many studies have demonstrated that CIN is associated with in-hospital and long-term mortality, the incidence of CIN following CAS is unclear. We investigated the incidence of CIN, defined as an increase from a baseline creatinine value of at least 0.5 mg/dL or 25% within 72 hours of contrast administration, and we also examined renal function in the late phase after CAS.

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N-Acetylcysteine In The Prevention Of Radiocontrast-Induced Nephropathy

Cited by 177 publications

References 102 publications

Ongoing Clinical Trials in AKI

Ongoing Clinical Trials in AKI

Clinical Pharmacology, Uses, and Adverse Reactions of Iodinated Contrast Agents: A Primer for the Non-radiologist

Prolonged Carotid Sinus Reflex Is a Risk Factor for Contrast-Induced Nephropathy following Carotid Artery Stenting

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