BACKGROUND AND OBJECTIVES: N-acetylcysteine (NAC) has been widely used as a prophylactic therapy for contrast-induced nephropathy (CIN). Its efficacy is controversial because of heterogeneity in study results and because of evidence that NAC can alter serum creatinine levels without affecting glomerular filtration rate. This confounding effect of N-acetylcysteine on serum creatinine has not been rigorously tested, however, in a population at risk for CIN and following doses of NAC currently recommended for prophylaxis of CIN. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: "Double-dose" NAC was administered in the absence of iodinated contrast media to 29 stage 3 to 5 stable chronic kidney disease patients. Serum creatinine and cystatin C were measured before and 4 h and 48 h after the last dose of NAC. RESULTS: There was no effect of NAC on either serum creatinine or cystatin C levels. CONCLUSION: NAC, in doses currently recommended for prophylaxis of CIN, has no effect on serum creatinine or cystatin C levels. It is therefore unlikely that the heterogeneity seen in clinical trials of NAC prophylaxis for CIN is related to a confounding effect on serum creatinine.
BACKGROUND AND OBJECTIVES:N-acetylcysteine (NAC) has been widely used as a prophylactic therapy for contrast-induced nephropathy (CIN). Its efficacy is controversial because of heterogeneity in study results and because of evidence that NAC can alter serum creatinine levels without affecting glomerular filtration rate. This confounding effect of N-acetylcysteine on serum creatinine has not been rigorously tested, however, in a population at risk for CIN and following doses of NAC currently recommended for prophylaxis of CIN. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: "Double-dose" NAC was administered in the absence of iodinated contrast media to 29 stage 3 to 5 stable chronic kidney diseasepatients. Serum creatinine and cystatin C were measured before and 4 h and 48 h after the last dose of NAC. RESULTS: There was no effect of NAC on either serum creatinine or cystatin C levels. CONCLUSION:NAC, in doses currently recommended for prophylaxis of CIN, has no effect on serum creatinine or cystatin C levels. It is therefore unlikely that the heterogeneity seen in clinical trials of NAC prophylaxis for CIN is related to a confounding effect on serum creatinine.
Authors: Shai Efrati; Victor Dishy; Michael Averbukh; Alex Blatt; Ricardo Krakover; Joshua Weisgarten; Jason D Morrow; Michael C Stein; Ahuva Golik Journal: Kidney Int Date: 2003-12 Impact factor: 10.612
Authors: Ute Hoffmann; Michael Fischereder; Bernd Krüger; Wolfgang Drobnik; Bernhard K Krämer Journal: J Am Soc Nephrol Date: 2004-02 Impact factor: 10.121
Authors: Susanne B Nicholas; Jun Yuan; Amin Aminzadeh; Keith C Norris; Albert Crum; Nosratola D Vaziri Journal: Am J Transl Res Date: 2012-07-20 Impact factor: 4.060
Authors: Jeremiah R Brown; John F Robb; Clay A Block; Anton C Schoolwerth; Aaron V Kaplan; Gerald T O'Connor; Richard J Solomon; David J Malenka Journal: Circ Cardiovasc Interv Date: 2010-06-29 Impact factor: 6.546
Authors: Jeremiah R Brown; Peter A McCullough; Mark E Splaine; Louise Davies; Cathy S Ross; Harold L Dauerman; John F Robb; Richard Boss; David J Goldberg; Frank A Fedele; Mirle A Kellett; William J Phillips; Peter N Ver Lee; Eugene C Nelson; Todd A MacKenzie; Gerald T O'Connor; Mark J Sarnak; David J Malenka Journal: BMJ Qual Saf Date: 2011-09-02 Impact factor: 7.035
Authors: Salvatore Grisanti; Deborah Cosentini; Valeria Tovazzi; Susanna Bianchi; Barbara Lazzari; Francesca Consoli; Elisa Roca; Alfredo Berruti; Vittorio D Ferrari Journal: Support Care Cancer Date: 2018-03-15 Impact factor: 3.603
Authors: Richard J Solomon; Roxana Mehran; Madhu K Natarajan; Serge Doucet; Richard E Katholi; Cezar S Staniloae; Samin K Sharma; Marino Labinaz; Joseph L Gelormini; Brendan J Barrett Journal: Clin J Am Soc Nephrol Date: 2009-06-25 Impact factor: 8.237