PHILADELPHIA — Giving N-acetylcysteine as an adjunctive agent may reduce the risk of acute renal injury following contrast imaging procedures in high-risk patients, Dr. Venkatesh Jayaraman reported at the annual meeting of the American Society of Nephrology.
Dr. Jayaraman, a nephrology fellow at Lankenau Hospital in Wynnewood, Pa., and associates reviewed the records of 380 patients who underwent coronary angiography in August 2001-January 2004, to evaluate a N-acetylcysteine protocol that was instituted in 2001.
Patients received 600 mg of oral N-acetylcysteine twice daily on the day before and the day of the procedure and were followed for 48 hours. By definition, low-risk patients had a serum creatinine level of 1.5 mg/dL or less; high-risk patients were those with more than 1.5 mg/dL.
Among the 318 low-risk patients, there were 8 cases (3%) of contrast-related acute renal failure (ARF). In the 62 high-risk patients, there were 12 cases of ARF (19%). In the low-risk group, 9% of patients received acetylcysteine, compared with 86% of those in the high-risk group.
The investigators concluded that acetylcysteine had a significant effect on the risk of ARF in high-risk, but not low-risk patients. Only about 10% of the high-risk patients who got the drug developed ARF.