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N-Acetylcysteine in the Prevention of Contrast-Induced Nephropathy

Winthrop-University Hospital, Mineola, New York, and State University of New York School of Medicine, Stony Brook, New York

Correspondence: Dr. Steven Fishbane, 200 Old Country Road, #135, Mineola, NY 11501. Phone: 516-663-2169; Fax: 516-663-2179; E-mail: sfishbane{at}winthrop.org

Background and objectives: Contrast-induced nephropathy (CIN) is a common clinical problem that is growing in importance as an increasing number of tests and procedures that utilize contrast media are performed.

Design, setting, participants, and measurements: The biological and pharmacological properties of n-acetylcysteine (NAC) are reviewed, as well as the current literature relevant to the ability of NAC to prevent CIN.

Results: After publication of a seminal study by Tepel et al. in 2000, there has been a surge in interest regarding the ability of NAC to reduce the risk for CIN. Since then a large number of studies, mostly with relatively small sample sizes, have been published.

Conclusions: The results have been remarkably varied with some studies finding great efficacy with NAC but most finding no significant benefit.