The Study of the Efficacy of N-Acetylcysteine for the Prevention of Contrast Induced Nephropathy in Normal Renal Functioning Patients Undergoing Coronary Angiography

Background and N-Acetylcysteine (NAC) has been found to reduce the risk of Contrast Induced Nephropathy (CIN) in chronic renal insufficiency after CT imaging with contrast enhancement. The purpose of the current study was to evaluate the efficacy of NAC, for the prevention of CIN in normal renal functioning patients undergoing coronary angiography. We prospectively studied 100 patients, who were undergoing coronary angiography with meglumin compound 76% (Urografin®), Patients were randomized one to two groups. Group one, IV hydration and NAC 600 mg PO were administered twice daily for 2 days (on the day prior to and on the day of coronary angiography). Group two, was administered IV hydration alone (Control Group). One hundred patients completed the study. There was no significant difference between the group in baseline characteristics, duration of angiography, mean volume of contrast agent infused or in mean IV hydration. Contrast nephropathy developed in 30% of subjects. 11/50 (22%) in NAC group and 19/50 (38%) in control group (P= 0.12). In control group, the mean of Createnin Serum Level significantly increased 48 hours after administration of the contrast agent (P=0.001). Our findings do not support routine prophylactic administration of oral NAC as an adjunct to saline hydration for prevention of contrast induced nephropathy, in patients with normal kidney, undergoing coronary angiography.