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N-acetylcysteine for Contrast Nephropathy: More Clinical Science Is Required—Reply
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In reply
In reply to the letter by Eddleston and colleagues, we generally concur and offer the following comments. We would like to first draw attention to, and reinforce, the broader issue discussed in our original article,1 specifically, that the literature on N-acetylcysteine and CIN embodies a missed opportunity for a greater coordination of research activity. We suggested how to prevent such a redundancy in the future.1
Eddleston et al further raise an important issue concerning the value of mechanistic studies preceding the conduct of large definitive trials because these smaller studies can provide crucial information (ie, dosing and timing) that increases the probability of a large trial being on the mark. We agree that the specific mechanism(s) through which N-acetylcysteine may protect the kidney from contrast-induced injury are yet incompletely understood. Whether these mechanisms include antioxidant activity, modulation of kidney endothelial function or hemodynamics remains uncertain; however, . . . [Full Text of this Article]
AUTHOR INFORMATION
Sean M. Bagshaw, MD, MSc;
Finlay A. McAlister, MD, MSc;
Braden J. Manns, MD, MSc;
William A. Ghali, MD, MPH
RELATED LETTER
N-acetylcysteine for Contrast Nephropathy: More Clinical Science Is Required
Michael Eddleston, Jane Goddard, and Nick Bateman
Arch Intern Med. 2006;166(15):1668-1669.
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.
ABSTRACT
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