N-acetylcysteine as a Preventive Measure for Contrast Induced Nephropathy in Intensive Care Patients with Renal Insufficiency.

Since contrast-induced nephropathy accounts for a significant increase of hospital-acquired renal failure, several strategies to prevent contrast-induced nephropathy are presently advocated, including the use of alternative imaging techniques (for which contrast media are not needed), the use of (the lowest possible amount of) iso-osmolar or low-osmolar contrast agents (instead of high-osmolar contrast agents), hyperhydration and forced diuresis.
Administration of N-acetylcysteine, theophylline or fenoldopam, sodium bicarbonate infusion, and peri-procedural hemofiltration/hemodialysis have been investigated as preventive measures in recent years.
Unfortunately, results from the several trials are divers, some show a beneficial effect, and some show no effect of the intervention at all. It is uncertain whether contrast-induced nephropathy is an important entity in intensive care medicine.
On the assumption that N-acetylcysteine might prevent acute contrast induced nephropathy in critically ill patients, we study the effects of prophylactic intravenous administration of N-acetylcysteine in critically ill patients with renal insufficiency.

On the assumption that N-acetylcysteine might prevent acute contrast induced nephropathy in critically ill patients, we study the effects of prophylactic intravenous administration of N-acetylcysteine in critically ill patients with renal insufficiency.

Patients are randomly assigned to receive either N-acetylcysteine before and after administration of the contrast agent (acetylcysteine group) or placebo at the same time points (control group).
N-acetylcysteine or placebo is given intravenously in a double blinded fashion.
N-acetylcysteine is given at a dose of 5000 mg on the day before and on the day of administration of the contrast agent, for a total of two days.