Acetylcysteine and contrast agent-associated nephrotoxicity

AbstractObjectivesProphylactic acetylcysteine along with hydration seems to be better than hydration alone in preventing the reduction in renal function induced by a contrast dye.BackgroundContrast media can lead to acute renal failure that may occasionally require hemodialysis.MethodsOne hundred eighty-three consecutive patients with impairment of renal function, undergoing coronary and/or peripheral angiography and/or angioplasty, were randomly assigned to receive 0.45% saline intravenously and acetylcysteine (600 mg orally twice daily; group A, n = 92) or 0.45% saline intravenously alone (group B, n = 91) before and after nonionic, low-osmolality contrast dye administration.ResultsThe baseline serum creatinine concentrations were similar (1.5 ± 0.4 mg/dl in group A vs. 1.5 ± 0.4 mg/dl in group B; p = 0.37). An increase of ≥25% in the baseline creatinine level 48 h after the procedure occurred in 6 (6.5%) of 92 patients in group A and in 10 (11%) of 91 patients in group B (p = 0.22). In the subgroup with a low (