J Korean Soc Emerg Med.  2007 Dec;18(6):570-576.

Is Oral N-acetylcysteine Effective on the Prevention of Radiocontrast induced Nephropathy in Patients with Acute Renal Failure?

• Jeong KY
• Suh GJ
• Kim KS
• Jo YH

Abstract

PURPOSE: N-acetylcysteine (NAC) has been known to have protective effects on the prevention of radiocontrast induced nephropathy (RCIN) in chronic renal failure (CRF). We investigated the effects of NAC in acute renal failure (ARF).
METHODS
From January to June 2006, we retrospectively enrolled patients with ARF who were checked with contrast computed tomography (CT) at an emergency department. We divided patients into the NAC group and the control group. We compared baseline demographic characteristics, underlying diseases, infused fluid volume, blood urea nitrogen (BUN), and serum creatinine (Cr) level before and after CT scan. ARF was defined as serum Cr>1.5. mg/dL. RCIN was defined as an increase in serum Cr level of at least 0.5 mg/dL or 25% 48 hours after CT.
RESULTS
Of a total 106 cases, 23 patients were the NAC group and 83 were the control group. There were no significant differences in baseline findings including underlying disease, cause of ARF and serum Cr level. The volume of infused fluid before and after CT were not different between the two groups (before; p=0.183 after; p=0.149). After CT scan, BUN and serum Cr level were decreased without statistical significance in both groups (NAC vs control group: BUN; 21.0+/-12.9 vs 20.5+/-14.2 p=0.863 Cr; 1.3+/-0.5 vs 1.4+/-0.5 p=0.451). RCIN developed in total 3 cases, 2 cases in the NAC group and 1 in the control group (p=0.524) and one of the NAC group performed hemodialysis.
CONCLUSION
In case of patients with ARF, there was no protective effect of NAC on RCIN.

Keyword

N-acetylcysteine; Radiocontrast induced nephropathy; Acute Renal Failure

MeSH Terms

Acetylcysteine*
Acute Kidney Injury*
Blood Volume
Creatinine
Emergency Service, Hospital
Humans
Kidney Failure, Chronic
Nitrogen
Renal Dialysis
Retrospective Studies
Tomography, X-Ray Computed
Urea
Acetylcysteine
Creatinine
Nitrogen
Urea