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

Jeong,  Ki Young; Suh,  Gil Joon; Kim,  Kyu Seok; Jo,  You Hwan

J Korean Soc Emerg Med > Volume 18(6); 2007 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2007;18(6): 570-576.

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

Ki Young Jeong, Gil Joon Suh, Kyu Seok Kim, You Hwan Jo

¹Department of Emergency Medicine, College of Medicine, Seoul National University, Korea. suhgil@snuh.org
²Department of Emergency Medicine, Seoul National University Bundang Hospital, Korea.

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.

Key words: N-acetylcysteine, Radiocontrast induced nephropathy, Acute Renal Failure