Meta-analysis investigates N-acetylcysteine's effectiveness in preventing acute kidney injury during contrast use, suggesting limited benefit.
This study aimed to determine the effect of N-acetylcysteine (NAC) in preventing contrast-induced nephropathy. A literature search was carried out in PubMed and Cochrane CENTRAL, and 49 studies were finally included. With oral NAC, there was no difference in the incidence of acute kidney injury (AKI; OR: 1.00; 95% CI: 0.90- 1.11; p = 0.98), the need for haemodialysis (HD; OR: 0.94; 95% CI: 0.61- 1.46; p = 0.79), or mortality (OR: 1.08; 95% CI: 0.83- 1.41; p = 0.55). The results were not affected during subgroup analysis for low- or high-dose oral NAC. With intravenous (IV) NAC, there was no difference in the incidence of AKI (OR: 0.84; 95% CI: 0.67- 1.04; p = 0.19), the need for HD (OR: 0.74; 95% CI: 0.19- 2.86; p = 0.66), or mortality (OR: 1.11; 95% CI: 0.67- 1.85; p = 0.68). Neither oral nor IV NAC decreases the risk of contrast-induced nephropathy.
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Rafique et al. (2026) studied this question.