Prevention of Radiocontrast-Induced Nephropathy after Coronary Angiography: N-Acetylcysteine plus Saline Hydration versus Saline Hydration

Purpose: To compare the incidence of radiocontrast-induced nephropathy (RCIN) in patients undergoing coronary angiography pretreated with N-acetylcysteine NAC plus saline hydration or saline hydration alone and to determine the association between various risk factors and RCIN.
Methods: Patients were retrospectively evaluated over a one-year period. RCIN was defined as an acute rise in serum creatinine of at least 0.5 mg/dl or more than 25 % from baseline value. SPSS software, version 13 was used for data analysis.
Results: Overall, 299 patients were studied. Thirteen patients (4.3%) developed RCIN. RCIN was 3.3 % in patients treated with hydration, and 8.3 % in patients treated with NAC plus hydration (p = 0.09). In patients with RCIN, the changes in creatinine and % change in creatinine after 24 h were significantly lower in the NAC plus hydration group (p = 0.039 and p = 0.042, respectively). RCIN was significantly associated with male gender (p = 0.017), history of renal failure (p = 0.006), ischemic heart disease (p = 0.003), and diuretic treatment (p = 0.013).
Conclusion: NAC plus saline hydration may not be more effective than saline hydration alone in decreasing RCIN after coronary angiography. Additional efforts to find an ideal preventive treatment are needed.

Keywords
Coronary angiography, N-acetylcysteine, Radiocontrast-induced nephropathy, Saline hydration