Preventing radiocontrast-induced nephropathy in chronic kidney disease patients undergoing coronary angiography

Table 5 Clinical trials comparing IV N-acetylcysteine and control after angiography procedure

Ref.	NAC dosing regimen (cumulated NAC dose)	No. of patients (NAC:hydration)	Hydration protocol	Contrast media type (mean dose)	Results
Baker et al[103] (2003) coronary angiography	150 mg/kg over 30 min before and 50 mg/kg over 4 h after (200 mg/kg)	41:39	0.9% NaCl 1 mL/kg per hour for 12 h pre- and post-procedure	IOCM iodixanol (253 mL)	5% vs 21% (RR = 0.28, P = 0.045)
Kefer et al[105] (2003) coronary angiography	1200 mg 12 h before 1200 mg immediately after the procedure (2.4 g)	53:51	0.9% NaCl 200 mL 12 h pre- and D5W 20 mL/h for 12 h pre and post-procedure	LOCM iopromide/iohexol (199 mL)	3.8% vs 5.9 % (P = 0.98)
Rashid et al[107] (2004) peripheral angiography	2 doses of 1000 mg at 6-12 h before and after the procedure (2 g)	46:48	2 doses of 0.9% NaCl 500 mL over 4-6 h at 6-12 h before and after the procedure	LOCM iohexol 143 mL)	pts. CrCl < 70 mL/min 7.7% vs 8.8% (P = 1.0)
Webb et al[109] (2004) coronary angiography	500 mg in D5W/0.9% NaCl 50 mL for 15 min as a bolus within 1 h before the procedure (500 mg)	242:245	D5W/0.9% NaCl 50 mL as a bolus within 1 h before the procedure and 200 mL 0.9% NaCl	LOCM ioversol (136 mL)	23.3% vs 20.7% (P = 0.51)
Kotlyar et al[110] (2005) cardiac or peripheral angiography	Gr 1: 300 mg × 2 (600 mg)	41:19	0.9% NaCl 1 mL/kg per hour	LOCM iopromide	0% vs 0 %
	Gr 2: 600 mg × 2 (1.2 g)
Carbonell et al[104] (2007) coronary angiography	600 mg twice daily (2.4 g)	107:109	0.45% intravenous saline	LOCM iopromide (193 mL)	10.3% vs 10.1% (P = 0.5)
Koc et al[102] (2010) coronary angiography and/or PCI	600 mg twice daily before and on the day of the coronary procedure (total = 2.4 g)	80:801:602	0.9% saline	LOCM iohexol 138 ± 47 mL)	2.5% vs 16.3% vs 10.0% (P = 0.012)

¹High-dose hydration group: IV 0.9% saline 1 mL/kg per hour before, on and after the day of coronary procedure (5334 ± 783 mL);

²Standard hydration group: IV 0.9% saline 1 mL/kg per hour for 12 h (1893 ± 270 mL). NAC: N-acetylcysteine; RCIN: Radiocontrast induced nephropathy; RR: Relative risk; CrCl: Creatinine clearance; NaCl: Sodium chloride; D5W: 5% dextrose; IOCM: Iso-osmolar contrast media; LOCM: Low-osmolar contrast media; PCI: Percutaneous coronary intervention.