N-Acetylcysteine in the Prevention of Contrast-Induced Nephropathy

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.