Effect of N‑acetyl cysteine in prevention of contrast nephropathy on patients under intravenous pyelography and contrast CT

Contrast nephropathy is a common and often reversible cause of acute renal failure (ARF). About 10% of ARF in admitted patients might be due to it and may also lead to dialysis. Some methods could prevent it such as fluid therapy with half or normal saline, Na bicarbonate, N-acetyl cysteine (NAC), and so on. The aim of this study was to evaluate the efficacy of NAC to prevent contrast nephropathy.

In a cross-sectional study, 110 patients who were candidate for intravenous pyelography (IVP) or CT scan enrolled in two groups: Case and control. In patients of case group, meglumine compound and in control group, placebo was prescribed before procedure. Before study and after 48 h, blood urea nitrogen (BUN) and creatinine (Cr) was checked, and glomerular filtration rate (GFR) was measured with Cockcroft-Gault formula.

There were no difference between age and gender of two groups. There was also no significant difference between mean Cr before and after study; however, GFR of patients in case group was significantly higher than the control group after 48 h of procedure.

Because GFR was higher in case group and there were no drug side-effects in patients, we recommend the use of NAC before administration of intravenous contrast especially in high-risk population such as diabetic patients.