Original investigation: pathogenesis and treatment of kidney disease and hypertensionEffect of N-acetylcysteine for prevention of contrast nephropathy in patients with moderate to severe renal insufficiency: a randomized trial
Section snippets
Methods
We enrolled consecutive patients with a serum creatinine level of 1.69 to 4.52 mg/dL (149 to 400 μmol/L) who underwent elective coronary angiography or intervention. The indication for angiography was determined by individual cardiologists. All patients had 2 serum creatinine measurements within 1 month before coronary angiography, with intraindividual fluctuation less than 15% to confirm stable renal function before recruitment. Patients with a known allergy to NAC or contrast agents were
Results
There were 46 patients enrolled in the NAC group, and 45 patients, in the control group. Baseline clinical characteristics are listed in Table 1. The NAC group had marginally more patients who had hypertensive nephrosclerosis, were administered aspirin, had renal artery stenosis, had a greater dose of contrast administered, and had a greater estimated GFR at baseline and fewer patients who were administered angiotensin receptor antagonist than the control group, although none of the
Discussion
In this randomized study, there was no difference in incidence of CN between NAC with hydration and hydration alone in patients with moderate to severe renal insufficiency undergoing coronary angiography or interventions. Moreover, there also was no difference in changes in serum creatinine levels or estimated GFRs between the 2 arms. In logistic regression analysis, none of the potential variables, including treatment strategy, predicted the primary end point. Although it has been suggested
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