Efficacy of N-Acetylcysteine in Prevention of Post-Catheterization Contrast-Induced Nephropathy in Diabetic Patients With Chronic Kidney Disease

Summary

* Contrast-induced nephropathy (CIN) is the third most common cause of hospital acquired acute kidney injury, accounting for 10% of all cases. * The pathophysiology of CIN is unclear. Possible mechanisms involve 1. Renal tubular injury by oxygen free radicals 2. Reducing renal blood flow which leads to acute tubular necrosis. Since N-acetylcysteine is an antioxidant as well as a vasodilator, it may work in two distinct ways, by preventing reduction in renal blood flow or contrast-induced oxidative damage. * The purpose of this study is to evaluate the efficacy of N-acetylcysteine compared to placebo for the contrast-induced nephropathy prevention.

Timeline

Start

2006-04

Primary completion

2006-10

Completion

2006-10

Outcome

Missed primary endpoint

paper 6 out of 42 (14.3%) patients in the placebo group (P = 0.656). PMID 19563648 ↗

paper There was no detectable benefit for the prophylactic administration of oral NAC over an aggressive hydration protocol in patients with DM and CKD. PMID 19563648 ↗

Publications

• Amini M, Salarifar M, Amirbaigloo A, Masoudkabir F, Esfahani F. N-acetylcysteine does not prevent contrast-induced nephropathy after cardiac catheterization in patients with diabetes mellitus and chronic kidney disease: a randomized clinical trial. Trials. 2009 Jun 29;10:45. doi: 10.1186/1745-6215-10-45.

Drugs

Evaluation	Drug	Modality	Dose	Route
Subject	N-acetylcysteine	Small molecule	600 mg	Oral

Indications