N-Acetylcysteine or Ascorbic Acid Versus Placebo to Prevent Contrast-Induced Nephropathy in Patients With Renal Insufficiency Undergoing Elective Cardiac Catheterization: A Single Center, Prospective, Double-Blind, Placebo-Controlled, Randomized Trial

Brueck, Martin; Cengiz, Huelya; Boening, Andreas

doi:10.1016/s0735-1097(11)60595-0

Cited by 27 publications

(35 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Interestingly, the RCT which enrolled only diabetes patients (n ¼ 134) showed higher incidence of CIN in the NAC group than group of hydration only (9.2% vs. 1.4%) without difference between the two groups for the mean maximal change in serum Cr measured 48-96 h after angiography, 33 but it should be noted that most patients in this RCT had a normal level of SCr. Another RCT 10 included in our study demonstrated lower incidence of CIN in the NAC group than the placebo group (28.4% vs. 35.0%) in 188 patients with both renal impartment and diabetes, although the benefit of NAC in prevention for CIN was not significant.…”

Section: Prevention Of Cin In Patients With Diabetescontrasting

confidence: 49%

“…However, recently in some randomized clinical trials, the benefit of NAC therapy for prevention of CIN had not been found in the population with pre-existing renal dysfunction or diabetes. 10,11 We therefore performed a meta-analysis of the randomized controlled trials (RCTs) in order to evaluate the efficacy of NAC for the prevention of CIN among patients with pre-existing renal insufficiency or diabetes.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

N-acetylcysteine for the prevention of contrast-induced nephropathy in patients with pre-existing renal insufficiency or diabetes: a systematic review and meta-analysis

Kang

et al. 2015

Renal Failure

View full text Add to dashboard Cite

(2015) Nacetylcysteine for the prevention of contrast-induced nephropathy in patients with pre-existing renal insufficiency or diabetes: a systematic review and meta-analysis, Renal Failure, 37:10,[297][298][299][300][301][302][303] 2 ¼ 5% for the group of diabetes). Conclusion: Our results suggest that NAC decreases the incidence of contrast-induced nephropathy among patients with pre-existing renal insufficiency. The benefit was not existed in patients with diabetes.

show abstract

Section: Prevention Of Cin In Patients With Diabetescontrasting

confidence: 49%

Section: Introductionmentioning

confidence: 99%

N-acetylcysteine for the prevention of contrast-induced nephropathy in patients with pre-existing renal insufficiency or diabetes: a systematic review and meta-analysis

Kang

et al. 2015

Renal Failure

View full text Add to dashboard Cite

show abstract

“…Recently, Brueck et al [92] prospectively randomized 520 patients who were undergoing CAG into 3 groups to receive (1) ascorbic acid 500 mg 24 h and 1 h before procedure, (2) NAC 600 mg 24 h and 1 h before procedure, and (3) placebo. All patients received intravenous 0.9% NaCl at a rate of 1 mL/kgBW/h from 12 h before to 12 h after the procedure.…”

Section: Pharmacological Strategies To Prevent Ci-akimentioning

confidence: 99%

Pharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

Pattharanitima

Tasanarong

2014

BioMed Research International

View full text Add to dashboard Cite

Contrast-induced acute kidney injury (CI-AKI) is the most common iatrogenic cause of acute kidney injury after intravenous contrast media administration. In general, the incidence of CI-AKI is low in patients with normal renal function. However, the rate is remarkably elevated in patients with preexisting chronic kidney disease, diabetes mellitus, old age, high volume of contrast agent, congestive heart failure, hypotension, anemia, use of nephrotoxic drug, and volume depletion. Consequently, CI-AKI particularly in high risk patients contributes to extended hospitalizations and increases long-term morbidity and mortality. The pathogenesis of CI-AKI involves at least three mechanisms; contrast agents induce renal vasoconstriction, increase of oxygen free radicals through oxidative stress, and direct tubular toxicity. Several strategies to prevent CI-AKI have been evaluated in experimental studies and clinical trials. At present, intravascular volume expansion with either isotonic saline or sodium bicarbonate solutions has provided more consistent positive results and was recommended in the prevention of CI-AKI. However, the proportion of patients with risk still develops CI-AKI. This review critically evaluated the current evidence for pharmacological strategies to prevent CI-AKI in patients with a risk of developing CI-AKI.

show abstract

“…Despite the absence of side effects, their findings did not warrant the use of antioxidants as a standard of care to prevent CIN. Another study conducted by Brueck et al [54] indicated that there was no evidence that standard dosage of NAC or ascorbic acid administered intravenously the day before and on the day of contrast dye exposure provided any benefit over placebo with respect to CIN prevention in patients with renal insufficiency undergoing cardiac catheterisation. They suggested that correct indication for the contrast media administration, peri-procedural hydration, the use of a small amount of low-osmolality contrast agent, and the avoidance of repetitive administration of closely spaced contrast dye remain the most important determinants in the prevention of CIN.…”

Section: Discussionmentioning

confidence: 99%

Protective effects of anti-oxidant supplementations on contrast-induced nephropathy after coronary angiography: an updated and comprehensive meta-analysis and systematic review

et al. 2016

View full text Add to dashboard Cite

A b s t r a c t Background and aim:This systematic review with meta-analysis sought to determine the strength of evidence for effects of antioxidants (AO) such as N-acetyl cysteine (NAC), vitamin C, vitamin E, and alpha-lipoic acid on the incidence of contrast-induced nephropathy (CIN), requirement for haemodialysis, level of serum creatinine, and mortality after coronary angiography. Methods and results:After Medline, Embase, Elsevier, Sciences online database, and Google Scholar literature searches, studies with randomised controlled design were selected for the meta-analysis. The effect sizes measured were odds ratio (OR) for categorical variables and standard mean difference (SMD) with 95% confidence interval (CI) for calculating differences between mean changes of serum creatinine in intervention and control groups. A value of p < 0.1 for Q test or I 2 > 50% indicated significant heterogeneity between the studies. Literature search of all major databases retrieved 2350 studies. After screening, a total of 49 trials were identified that reported outcomes. Pooled treatment effect analysis revealed that NAC (OR of 0.79; 95% CI 0.69-0.9; p = 0.000), vitamin C (0.63; 95% CI 0.45-0.89; p = 0.000), and vitamin E (OR of 0.5; 95% CI 0.27-0.92; p = 0.026) could significantly reduce the incidence of CIN. NAC (SMD of -0.119; 95% CI -0.191 --0.046; p = 0.000), but not vitamin C (SMD of -0.08; 95% CI -0.22-0.04; p = 0.1) and vitamin E (-0.25; 95% CI -0.46--0.05; p = 0.1), could significantly reduce mean levels of serum creatinine. Nevertheless, AO could not reduce the incidence of mortality, with an OR of 0.94 (95% CI 0.69-1.28; p = 0.7). Conclusions:Overall, antioxidants such as NAC, vitamin C, and vitamin E can reduce the incidence of CIN, while only NAC might be able to significantly lower serum creatinine levels. There is no impact of AO supplementation on mortality.

show abstract

N-Acetylcysteine or Ascorbic Acid Versus Placebo to Prevent Contrast-Induced Nephropathy in Patients With Renal Insufficiency Undergoing Elective Cardiac Catheterization: A Single Center, Prospective, Double-Blind, Placebo-Controlled, Randomized Trial

Cited by 27 publications

References 0 publications

N-acetylcysteine for the prevention of contrast-induced nephropathy in patients with pre-existing renal insufficiency or diabetes: a systematic review and meta-analysis

N-acetylcysteine for the prevention of contrast-induced nephropathy in patients with pre-existing renal insufficiency or diabetes: a systematic review and meta-analysis

Pharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

Protective effects of anti-oxidant supplementations on contrast-induced nephropathy after coronary angiography: an updated and comprehensive meta-analysis and systematic review

Contact Info

Product

Resources

About