Different routes of N-acetylcysteineon administration in preventing contrast-induced nephropathy in mild renal impairment patients undergoing contrast-enhanced CT

Objective To explore the preventive effect of oral and intravenous administration of N-acetylcysteine(NAC) on contrast-induced nephropathy(CIN) in patients with mild renal impairment undergoing contrast-enhanced CT.Methods A total of 97 patients with mild renal impairment undergoing contrast-enhance...

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Main Authors: XU Xiao, HUANG Min, DU Li-guo, LI Xiao-ning
Format: Article
Language:zho
Published: Editorial Department of Journal of Clinical Nephrology 2015-01-01
Series:Linchuang shenzangbing zazhi
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Online Access:http://www.lcszb.com/thesisDetails?columnId=57920485&Fpath=home&index=0
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Summary:Objective To explore the preventive effect of oral and intravenous administration of N-acetylcysteine(NAC) on contrast-induced nephropathy(CIN) in patients with mild renal impairment undergoing contrast-enhanced CT.Methods A total of 97 patients with mild renal impairment undergoing contrast-enhanced CT procedures were enrolled in this study.According to the random number table,all patients were divided into oral NAC group(n = 48) and intravenous group(n = 49).In oral NAC group,24 h before and after the contrast-enhanced CT scan,1 200 mg NAC was administrated orally twice a day,and 10%glucose(250 mL) was injected intravenously 1 h before the CT scan.In intravenous NAC group,4 g NAC dissolved in 10%glucose(250 mL) was given by intravenous injection 1 h before the CT scan and re-injected on the second day.All patients received 0.9%saline(500 ml) immediate after the contrast-enhanced CT scan.Serum creatinine(SCr),Cystatin C(Cys C) and estimated glomerular filtration rate(eGFR) levels were assessed at baseline and 48 h after the contrast-enhanced CT scan,and the incidence of CIN was analyzed.Results The levels of SCr and Cys C after the contrast-enhanced CT scan had an increasing tendency in oral NAC group(P<0.05),and eGFR had a decreasing tendency after the contrast-enhanced CT scan(P<0.05).There was no significant in levels of SCr,Cys C and eGFR before and fter the contrast-enhanced CT scan in intravenous NAC group(P>0.05).The levels of SCr and Cys C after the contrast-enhanced CT scan had an increasing tendency in oral NAC group compared with intravenous NAC group,and eGFR had a decreasing dendency.CIN occurred in one patient of intravenous NAC group,and 8 in oral NAC group(X~2 = 4.547,P= 0.033).Conclusions The effect of intravenous NAC administration was better than oral administration in preventing CIN.For the patients with mild renal insufficiency,intravenous NAC should be given before and after the contrast-enhanced CT to prevent CIN.
ISSN:1671-2390