Prevention of Radiocontrast-Induced Nephropathy After Coronary Angiography: N-Acetylcysteine Plus Saline Hydration Versus Saline Hydration

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Journal Title, Volume, Page: 
Tropical Journal of Pharmaceutical Research April 2011; 10 (2): 133-140
Year of Publication: 
2011
Authors: 
Yahaya Hassan
Clinical Pharmacy Program, College of Pharmaceutical Science, Universiti Sains Malaysia (USM), Penang, Malaysia
Zainol A Zainal
Clinical Pharmacy Program, College of Pharmaceutical Science, Universiti Sains Malaysia (USM), Penang, Malaysia
Noorizan A Aziz
Clinical Pharmacy Program, College of Pharmaceutical Science, Universiti Sains Malaysia (USM), Penang, Malaysia
Samah W Al-Jabi
Clinical Pharmacy Program, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM)
Current Affiliation: 
Department of Pharmacy, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
Omar Ismail
Cardiology Department, Hospital Pulau Pinang, Penang, Malaysi
Preferred Abstract (Original): 

Purpose: To compare the incidence of radiocontrast-induced nephropathy (RCIN) in patients undergoing coronary angiography pretreated with N-acetylcysteine NAC plus saline hydration or saline hydration alone and to determine the association between various risk factors and RCIN.
Methods: Patients were retrospectively evaluated over a one-year period. RCIN was defined as an acute rise in serum creatinine of at least 0.5 mg/dl or more than 25 % from baseline value. SPSS software, version 13 was used for data analysis.
Results: Overall, 299 patients were studied. Thirteen patients (4.3%) developed RCIN. RCIN was 3.3 % in patients treated with hydration, and 8.3 % in patients treated with NAC plus hydration (p = 0.09). In patients with RCIN, the changes in creatinine and % change in creatinine after 24 h were significantly lower in the NAC plus hydration group (p = 0.039 and p = 0.042, respectively). RCIN was significantly associated with male gender (p = 0.017), history of renal failure (p = 0.006), ischemic heart disease (p =0.003), and diuretic treatment (p = 0.013).
Conclusion: NAC plus saline hydration may not be more effective than saline hydration alone in decreasing RCIN after coronary angiography. Additional efforts to find an ideal preventive treatment are needed.

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