Usefulness of N-acetylcysteine or Ascorbic Acid Versus Placebo to Prevent Contrast-Induced Acute Kidney Injury in Patients Undergoing Elective Cardiac Catheterization: A Single-Center, Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

作者：Brueck Martin^*; Cengiz Huelya; Hoeltgen Reinhard; Wieczorek Marcus; Boedeker Rolf Hasso; Scheibelhut Christine; Boening Andreas

来源：Journal of Invasive Cardiology, 2013, 25(6): 276-283.

• contrast-induced acute kidney injury
• contrast media complications
• N-acetylcysteine
• ascorbic acid

Background. Contrast-induced acute kidney injury (CI-AKI) is a serious complication of procedures requiring contrast media associated with rising costs, prolonged hospitalization, and increased mortality. The aim of this study was to assess whether prophylactic administration of standard dosages of intravenous N-acetylcysteine or ascorbic acid reduce the incidence of CI-AKI in patients with chronic renal insufficiency undergoing elective cardiac catheterization. Methods. In a single-center, prospective, randomized, double-blind, placebo-controlled trial, the preventive effects of N-acetylcysteine and ascorbic acid were evaluated in 520 patients with chronically impaired renal serum creatinine %26gt;= 1.3 mg/dL) undergoing elective cardiac catheterization. The study drugs (600 mg N-acetylcysteine, 500 mg ascorbic acid, placebo) were administered intravenously twice (at 24 hours and 1 hour before the procedure). Serum creatinine, estimated glomerular filtration rate (eGFR) and serum urea were assessed at baseline and at 24 hours and 72 hours after contrast media exposure. CI-AKI was defined as a postangiographical increase in serum creatinine %26gt;= 0.5 mg/dL. Results. The incidence of CI-AKI was 27.6% in the N-acetylcysteine group (P=.20 vs placebo group) and in 24.5% in the ascorbic acid group (P=.11 vs placebo group). CI-AKI occurred in 32.1% of the placebo group. Conclusions. Standard doses of N-acetylcysteine and ascorbic acid did not prevent CI-AKI in patients at high risk undergoing cardiac catheterization with non-ionic, low-osmolality contrast agent.

• 出版日期2013-6
• 单位河北医科大学