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N-acetylcysteine for Contrast Nephropathy: More Clinical Science Is Required
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We read with interest the article by Bagshaw and colleagues1 on the evidence for the role of N-acetylcysteine in radiographic contrast-induced nephropathy (CIN) and agree with their conclusion that the current evidence base is weak. However, we do not agree that the next step is to establish a large high-quality multicenter RCT because the basic information needed to design such a trial is not yet available.
For example, we do not yet know how N-acetylcysteine might work in radiographic CIN. While findings from studies on animals suggest that N-acetylcysteine may protect against oxidative damage or prevent vasoconstriction of renal arteries, the mechanism has not been identified in patients.2-3 Establishing the mechanism is essential for identifying the outcome measures to use in future studies. At present, studies measure increases in serum creatinine concentration as markers of renal damage.1 However, in addition to serum creatinine concentration not being the . . . [Full Text of this Article]
AUTHOR INFORMATION
Michael Eddleston;
Jane Goddard;
Nick Bateman
RELATED LETTER
N-acetylcysteine for Contrast Nephropathy: More Clinical Science Is Required—Reply
Sean M. Bagshaw, Finlay A. McAlister, Braden J. Manns, and William A. Ghali
Arch Intern Med. 2006;166(15):1669.
EXTRACT
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RELATED ARTICLE
Acetylcysteine in the Prevention of Contrast-Induced Nephropathy: A Case Study of the Pitfalls in the Evolution of Evidence
Sean M. Bagshaw, Finlay A. McAlister, Braden J. Manns, and William A. Ghali
Arch Intern Med. 2006;166(2):161-166.
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