The efficacy of n-acetylcysteine in preventing contrast-induced nephropathy in type 2 diabetic patients without nephropathy

Abstract

Background: N-acetylcysteine (NAC) is reported to have potential for prevention of contrast-induced nephropathy(CIN), however, there is not enough data related to its effects on diabetic patients without nephropathy. Methods: A total of 45 diabetic patients without nephropathy undergoing a computerized tomography (CT) investigation and who would be receiving radio-opaque medication (300 mg iohexaol/100 mL) were enrolled. They were randomized to have either high-dose NAC (1200 mg) plus saline hydration (Group 1, n=25) or only saline hydration (Group 2; n=20). Serum creatinine levels were determined 72 hours post-contrast. CIN was defined as 0.3 mg/dL elevation of creatinine from baseline and/or an increment of 20% over baseline creatinine and/or 20% decrement of estimated GFR. Results: In Group 1, serum creatinine decreased from 0.83 to 0.79 mg/dL, whereas serum creatinine increased from 0.81 to 0.94mg/dL in Group 2 (not significant for both groups). However there was a significant difference between the creatinine variation of two groups (p=0.031). Furthermore, the groups were analyzed according to overall incidence of CIN. The increase of serum creatinine and decrement of estimated GFR in Group 2 were significantly higher than in Group 1. Conclusion: Adding NAC to saline hydration seems more beneficial than saline hydration alone in preventing contrast-induced renal function deterioration in type 2 diabetic patients without nephropathy. © 2010 Società Italiana di Nefrologia.