Response to "The value of hydration and acetylcysteine in the prevention of contrast-induced nephropathy: A potentially catastrophic complication of the percutaneous coronary interventions"

⁎ Corresponding author. E-mail address: chmengx@126.com (S.L. Chen). We thank Dr. Iyisoy et al. for their interest in our paper [1]. They summarized several articles in a remarkable way. There aremany preventive measures that can reduce the risk of CIN, including: different hydration regimens which included NS, 1/2 NS or NaCO3 solutions. In terms of Acetycysteine, the authors reviewed all the literature and the conclusion is to administer Acetycysteine to high risk patients. However, the dosage indicated in the literature was not consistent. The authors concluded that there is no consistent therapy for CIN and that prevention is the best method. The hypothesis that Acetycysteine might contribute to the reduction of contrastinduced nephropathy (CIN) was fully reported in their paper [2]. We completely agree with the authors' conclusion. As a matter of fact, in our prospective, multicenter, randomized study, we enrolled 936 patients after percutaneous coronary intervention (PCI) with normal and abnormal creatinine. We found that, 1. there are significant differences in incidence of CIN in normal and abnormal groups (43 vs. 104), 2. patients with CIN and pre-existing renal insufficiency experienced worse clinical outcomes, compared to patients with CIN in the normal group which usually follows a benign course, 3. there is no positive effect of hydration with 0.45NS on the prevention of CIN in normal renal function, and 4. combination of hydration andNAC has the potential to reduce the incidence of CIN for patients with renal group. Our study did not address the issue of dosage of Acetycysteine but we decided to give Acetycysteine in combination with hydration to patients with abnormal renal function and as a result, we observed a reduction of CIN of 37%. This magnitude of reduction could suggest that the combination of Acetycysteine and hydration is a good method of preventive therapy in patients with renal insufficiency undergoing percutaneous coronary intervention.