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Acetylcysteine has No Mechanistic Effect in Patients at Risk of Contrast-Induced Nephropathy - A Failure of Academic Clinical Science
Clin Pharmacol Ther. 2022 Jan 31. doi: 10.1002/cpt.2541. Online ahead of print.ABSTRACTContrast-induced nephropathy (CIN) is a major complication of imaging in patients with chronic kidney disease (CKD). The publication of an academic RCT (n=83) reporting oral (N)-acetylcysteine (NAC) to reduce CIN led to >70 clinical trials, 23 systematic reviews, and two large RCTs showing no benefit. However, no mechanistic studies were conducted to determine how NAC might work; proposed mechanisms included renal artery vasodilatation and antioxidant boosting. We evaluated the proposed mechanisms of NAC action in participants with he...
Source: Clinical Pharmacology and Therapeutics - January 31, 2022 Category: Drugs & Pharmacology Authors: Euan A Sandilands Jessica Mb Rees Khuram Raja Neeraj Dhaun Emma E Morrison Kirsty Hickson Jonathan Wraight Tanya Gray Lesley Briody Sharon Cameron Adrian P Thompson Neil R Johnston Neal Uren Jane Goddard Andy Treweeke Gordon Rushworth David J Webb D Nicho Source Type: research

Could Omega 3 fatty acids reduce the risk of contrast-induced nephropathy in patients undergoing coronary angiography? A randomized controlled trial
This study aimed to determine if omega 3 fatty acids reduce the risk of CIN in patients with chronic kidney disease undergoing coronary angiography. A total of 130 consecutive patients undergoing coronary angiography were randomly assigned to one of two groups as follows: 67 patients were assigned to the N-acetylcysteine (NAC; 1200 mg) and 63 patients were assigned to the omega 3 fatty acid (4 g). Both drugs were administered orally twice per day one day before and on the day of contrast administration. Of the 130 patients enrolled in this study, 10 (7.7%) experienced an increase of at least 0.5 mg/dL (44 μmol/L) in serum...
Source: Saudi Journal of Kidney Diseases and Transplantation - January 12, 2022 Category: Urology & Nephrology Authors: Fadel A Alrowaie Khalid I Almatham Faisal Alsamadi Muhammad Salman Bashir Humariya H Munshi Source Type: research

Role of N-Acetylcysteine to Prevent Contrast-Induced Nephropathy: A Meta-analysis
This study shows that NAC may not have any impact on clinical outcomes after peripheral or coronary artery catheterization and that dose and route do not seem to have any effect on these outcomes.
Source: American Journal of Therapeutics - January 1, 2016 Category: Drugs & Pharmacology Tags: Therapeutic Reviews Source Type: research

Does Ascorbic Acid Protect Against Contrast-induced Acute Kidney Injury in Patients Undergoing Coronary Angiography: A Systematic Review with Meta-Analysis of Randomized, Controlled Trials: Sadat U, Usman A, Gillard JH, Boyle JR. J Am Coll Cardiol 2013;62:2167–75.
Contrast-induced acute kidney injury (CI-AKI) is a ubiquitous and highly debated topic in medicine, particularly with the increasing use of contrast media in radiology and radiologically guided procedures. This meta-analysis of randomized, controlled trials sought to compare the use of ascorbic acid with placebo for the treatment of CI-AKI. Ascorbic acid is a potent antioxidant and therefore, could play a nephroprotective role in CI-AKI, which is thought to be driven at least in part by oxidative stress. A comprehensive literature search of MEDLINE, Embase, and the Cochrane central database generated nine randomized contr...
Source: The Journal of Emergency Medicine - February 27, 2014 Category: Emergency Medicine Authors: Ben Murphy Tags: Abstracts Source Type: research

The Role of N--Acetylcysteine in the Prevention of Contrast-Induced Nephropathy in Patients Undergoing Peripheral Angiography: A Structured Review and Meta-Analysis
In conclusion, insufficient evidence exists to recommend NAC for the prevention of CIN in patients undergoing peripheral angiography.
Source: Angiology - September 30, 2013 Category: Cardiology Authors: O'Sullivan, S., Healy, D. A., Moloney, M. C., Grace, P. A., Walsh, S. R. Tags: Reviews Source Type: research