N-acetylcysteine in contrast-induced acute kidney injury: clinical use against principles of evidence-based clinical medicine!

Abstract

Contrast-induced acute kidney injury (CI-AKI) is one of the most widely discussed and debated topic in cardiovascular medicine and N-acetylcysteine (NAC) is the most widely used pharmacological agent assessed in clinical trials for offering renal protection against CI-AKI. Results of these clinical trials are though split between those that favor its use and vice versa. In this brief communication we discuss the latest research advances regarding the use of NAC against CI-AKI. Recent clinical evidence and overview of in-depth statistical analyses of relevant clinical trials and their meta-analyses do not support the use of NAC in prophylaxis against CI-AKI. Adequate hydration before and after contrast media exposure, along with avoidance of nephrotoxic drugs, remains the recommended prophylaxis against CI-AKI.

• Authors: Umar Sadat
• Journal: Expert review of cardiovascular therapy (Expert Rev Cardiovasc Ther) Vol. 12 Issue 1 Pg. 1-3 (Jan 2014) ISSN: 1744-8344 [Electronic] England
• PMID: 24236859 (Publication Type: Editorial)

Chemical References

• Contrast Media
• Acetylcysteine

Topics

• Acetylcysteine (pharmacology)
• Acute Kidney Injury (chemically induced, diagnosis, drug therapy)
• Contrast Media (adverse effects)
• Evidence-Based Medicine
• Humans
• Kidney (drug effects)
• Treatment Outcome