Comparison of N-acetylcysteine, ascorbic acid, and normal saline effect in prevention of contrast-induced nephropathy

BACKGROUND: Considering the crucial role of appropriate preventative strategies in reducing the rate of contrast-induced nephropathy (CIN) occurrence and its related morbidity and mortality, the effect of N-acetylcysteine (NAC), ascorbic acid (AA), and normal saline (NS) was investigated in the patient’s undergone coronary angiography. METHODS: In this clinical trial, ۱۲۰ patients scheduled for elective coronary angiography with serum creatinine (Cr) level > ۱.۵ mg/dl or glomerular filtration rate (GFR) ≥ ۶۰ selected by convenience method. Selected patients were allocated in three treatment groups randomly to receive oral NAC (۶۰۰ mg/twice daily) plus NS (۱۰۰ ml/hour) (Group A), oral AA (۲۵۰ mg/twice daily) plus NS (۱۰۰ ml/hour) (Group B) and NS (۱۰۰ ml/hour) (Group C), respectively. The occurrence of CIN was evaluated based on serum Cr and GFR in three studied groups, before and after angiography procedure. The analysis of variance and paired t-test were used for data analysis by SPSS. RESULTS: The serum Cr increased and GFR decreased significantly during the intervention in three groups (P < ۰.۰۱۰). However, the amounts of these changes were equal between groups (P > ۰.۰۵۰). CONCLUSION: The study showed that nor the addition of NAC neither the addition of AA to sodium chloride infusion has more beneficial effect than hydration with sodium chloride, in the prevention of CIN.   

Keywords:

Contrast Media , N-acetylcysteine , Ascorbic Acid , Sodium Chloride Solution