N-acetyl cysteine versus allopurinol in the prevention of contrast nephropathy in patients with chronic kidney disease: A randomized controlled trial
Contrast media administration can lead to acute deterioration in renal function particularly in patients with pre-existing chronic kidney disease. This prospective, randomized controlled open-label parallel group study was undertaken at Nizam's Institute of Medical Sciences, Hyderabad, from Jun...
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| Published in | Indian journal of nephrology Vol. 27; no. 2; pp. 93 - 98 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
| Published |
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Medknow Publications and Media Pvt. Ltd
01.03.2017
Medknow Publications & Media Pvt. Ltd Medknow Publications & Media Pvt Ltd |
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| Abstract | Contrast media administration can lead to acute deterioration in renal function particularly in patients with pre-existing chronic kidney disease. This prospective, randomized controlled open-label parallel group study was undertaken at Nizam's Institute of Medical Sciences, Hyderabad, from June to December 2015. A total of 95 patients were included, of which 35 received n-acetylcysteine (NAC) + normal saline (NS), 30 patients received allopurinol (ALL) + NS, and 30 patients received placebo. In our study, the overall incidence of CIN was 24%. Incidence of CIN in NAC + NS, ALL + NS, and placebo group were 20%, 16%, and 36%, respectively. The major finding of this study was there was no significant difference between NAC and allopurinol in the prevention of contrast nephropathy. However, only allopurinol was superior to placebo. In our study, hyperuricemia and baseline serum creatinine were the only risk factors associated with CIN. |
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| AbstractList | Contrast media administration can lead to acute deterioration in renal function particularly in patients with pre-existing chronic kidney disease. This prospective, randomized controlled open-label parallel group study was undertaken at Nizam's Institute of Medical Sciences, Hyderabad, from June to December 2015. A total of 95 patients were included, of which 35 received n-acetylcysteine (NAC) + normal saline (NS), 30 patients received allopurinol (ALL) + NS, and 30 patients received placebo. In our study, the overall incidence of CIN was 24%. Incidence of CIN in NAC + NS, ALL + NS, and placebo group were 20%, 16%, and 36%, respectively. The major finding of this study was there was no significant difference between NAC and allopurinol in the prevention of contrast nephropathy. However, only allopurinol was superior to placebo. In our study, hyperuricemia and baseline serum creatinine were the only risk factors associated with CIN. |
| Audience | Academic |
| Author | Karthik, K R Swarnalatha, G Sadineni, R Taduri, G Das, U |
| AuthorAffiliation | Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India |
| AuthorAffiliation_xml | – name: Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/28356658$$D View this record in MEDLINE/PubMed |
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| Copyright | COPYRIGHT 2017 Medknow Publications and Media Pvt. Ltd. Copyright Medknow Publications & Media Pvt Ltd Mar-Apr 2017 Copyright: © 2017 Indian Journal of Nephrology 2017 |
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| Keywords | chronic kidney disease Allopurinol contrast nephropathy N-acetylcysteine |
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| References_xml | – start-page: 649 volume-title: Dosing of contrast material to prevent contrast nephropathy in patients with renal disease year: 1989 ident: key-10.4103/0971-4065.194397-4 publication-title: Am J Med contributor: fullname: Cigarroa – start-page: 728 volume-title: The use of radiographic contrast media during PCI: A focused review: A position statement of the Society of Cardiovascular Angiography and Interventions year: 2009 ident: key-10.4103/0971-4065.194397-18 publication-title: Catheter Cardiovasc Interv contributor: fullname: Klein – start-page: 227 volume-title: Hyperuricemia as a risk factor for contrast-induced nephropathy in patients with chronic kidney disease year: 2006 ident: key-10.4103/0971-4065.194397-16 publication-title: Catheter Cardiovasc Interv contributor: fullname: Toprak – start-page: 2773 volume-title: N-acetylcysteine and contrast-induced nephropathy in primary angioplasty year: 2006 ident: key-10.4103/0971-4065.194397-13 publication-title: N Engl J Med contributor: fullname: Marenzi – start-page: 1333 volume-title: The prevention of radiocontrast-agent-induced nephropathy by hemofiltration year: 2003 ident: key-10.4103/0971-4065.194397-6 publication-title: N Engl J Med contributor: fullname: Marenzi – start-page: 368 volume-title: Acute renal failure after coronary intervention: Incidence, risk factors, and relationship to mortality year: 1997 ident: key-10.4103/0971-4065.194397-1 publication-title: Am J Med contributor: fullname: McCullough – start-page: 1396 volume-title: Efficacy of allopurinol pretreatment for prevention of contrast-induced nephropathy: A randomized controlled trial year: 2013 ident: key-10.4103/0971-4065.194397-8 publication-title: Int J Cardiol contributor: fullname: Erol – start-page: HC03 volume-title: Comparative study of renal protective effects of allopurinol and N-acetyl-cysteine on contrast induced nephropathy in patients undergoing cardiac catheterization year: 2014 ident: key-10.4103/0971-4065.194397-9 publication-title: J Clin Diagn Res contributor: fullname: Kumar – start-page: 243 volume-title: Hospital-acquired renal insufficiency: A prospective study year: 1983 ident: key-10.4103/0971-4065.194397-2 publication-title: Am J Med contributor: fullname: Hou – start-page: 180 volume-title: Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine year: 2000 ident: key-10.4103/0971-4065.194397-11 publication-title: N Engl J Med contributor: fullname: Tepel – start-page: 501 volume-title: Risks for renal dysfunction with cardiac angiography year: 1986 ident: key-10.4103/0971-4065.194397-3 publication-title: Ann Intern Med contributor: fullname: Taliercio – start-page: 2837 volume-title: Ascorbic acid prevents contrast-mediated nephropathy in patients with renal dysfunction undergoing coronary angiography or intervention year: 2004 ident: key-10.4103/0971-4065.194397-5 publication-title: Circulation contributor: fullname: Spargias – start-page: 279 volume-title: Prospective randomized study of N-acetylcysteine, fenoldopam, and saline for prevention of radiocontrast-induced nephropathy year: 2002 ident: key-10.4103/0971-4065.194397-15 publication-title: Catheter Cardiovasc Interv contributor: fullname: Allaqaband – start-page: 2202 volume-title: A randomized controlled trial of N-acetylcysteine to prevent contrast nephropathy in cardiac angiography year: 2002 ident: key-10.4103/0971-4065.194397-14 publication-title: Kidney Int contributor: fullname: Durham – start-page: 361 volume-title: Extracorporeal blood purification therapies for prevention of radiocontrast-induced nephropathy: A systematic review year: 2006 ident: key-10.4103/0971-4065.194397-7 publication-title: Am J Kidney Dis contributor: fullname: Cruz – start-page: 449 volume-title: Reno-protective effect of N-acetyl cysteine in patients with impaired renal function undergoing coronary angiography and interventions year: 2006 ident: key-10.4103/0971-4065.194397-10 publication-title: J Assoc Physicians India contributor: fullname: Ramesh – start-page: 503 volume-title: Use and efficacy of saline hydration and N-acetyl cysteine to prevent contrast-induced nephropathy in low-risk populations undergoing coronary artery angiography year: 2011 ident: key-10.4103/0971-4065.194397-12 publication-title: Intern Emerg Med contributor: fullname: Calabrò – start-page: 819 volume-title: Impact of diabetic and pre-diabetic state on development of contrast-induced nephropathy in patients with chronic kidney disease year: 2007 ident: key-10.4103/0971-4065.194397-17 publication-title: Nephrol Dial Transplant contributor: fullname: Toprak |
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| SubjectTerms | Acetylcysteine Allopurinol Comparative analysis Dosage and administration Kidney diseases Original Prevention |
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| Title | N-acetyl cysteine versus allopurinol in the prevention of contrast nephropathy in patients with chronic kidney disease: A randomized controlled trial |
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