Prevention of radiocontrast-induced nephropathy with N-acetylcysteine in patients undergoing coronary angiography.

Objectives. Acetylcysteine in patients undergoing computerized tomography with intravenous contrast reduces the incidence of acute renal dysfunction. We examined the effect of N-acetylcysteine in patients undergoing coronary angiography. Methods. Fifty-five consecutive patients receiving 3 doses of N-acetylcysteine prior to cardiac catheterization were compared to 55 historical controls. All patients in both groups had baseline serum creatinine > 1.2 mg/dl and received intravenous hydration before and after the procedure. Serum creatinine levels at baseline and 48 hours after the procedure were compared. Results. Univariate analysis of clinical variables revealed no significant differences between the groups except for a higher baseline creatinine in the treatment group (2.0 ′ 0.7 vs. 1.8 ′ 0.4 mg/dl; p = 0.04). There was no difference in the amount or type of contrast used. The mean change in creatinine after 48 hours was -0.4 ′ 0.3 versus +0.1 ′ 0.3 mg/dl for treatment and control groups (p 2 mg/dl, the benefit was larger (-0.4 ′ 0.4 vs. +0.5 ′ 0.3 mg/dl; p 2 mg/dl.