Use of N-acetyl-cysteine to Prevent Nephrotoxicity Associated with Iodinated Contrast Agents
Mayank K. Mittal, Kanupriya Jain, Harsh Agrawal, Poonam Velagapudi, Sonal Dhuper and Arun Kumar
Affiliation: Division of Cardiovascular Medicine, University of Missouri School of Medicine, One Hospital Drive, CE 306 Columbia, MO 65212, USA.
Keywords: Acetylcysteine/therapeutic use, angiography/adverse effects, contrast media/adverse effects, humans, kidney
diseases/chemically induced, kidney diseases/prevention & control.
Contrast induced nephropathy (CIN) is an iatrogenic form of acute kidney injury (AKI) with variable but
growing prevalence secondary to increased need for contrast administration during medical investigations such as
coronary angiography. The mechanism of CIN is complex and poorly understood but is believed to be secondary to renal
medullary hypoxia secondary to direct tubular toxicity from the contrast media and vasoconstriction. N-acetylcysteine
(NAC) an antioxidant and vasodilator, has shown promising results in early investigations but failed to demonstrate
consistent results in subsequent clinical trials and their meta-analysis. In this review we aim to discuss pharmacological
properties of NAC and appraise the literature regarding the use of NAC for the prevention of CIN after coronary
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