Prevention of Radiocontrast-Induced Nephropathy after
Coronary Angiography: N-Acetylcysteine plus Saline
Hydration versus Saline Hydration
Yahaya Hassan1*,
Zainol A Zainal1, Noorizan A Aziz1,
Samah W Al-Jabi1 and Omar Ismail2
1Clinical
Pharmacy Program, School of Pharmaceutical Sciences,
Universiti Sains Malaysia (USM), 2Cardiology
Department, Hospital Pulau Pinang, Penang, Malaysia
*
For
correspondence:
E-mail:
yahaya@usm.my
Tel: +60195515611; Fax: +6046570017
Received: 27 August
2010 Revised
accepted: 2 March 2011
Tropical
Journal of Pharmaceutical Research, April
2011; 10(2):
133-140
Abstract
Purpose: To compare the incidence of
radiocontrast-induced nephropathy (RCIN) in patients
undergoing coronary angiography pretreated with
N-acetylcysteine NAC plus
saline hydration or saline hydration alone and to
determine the association between various risk factors
and RCIN.
Methods: Patients
were retrospectively evaluated
over a one-year period. RCIN was defined as an
acute rise in serum creatinine of at least 0.5 mg/dl or
more than 25 % from baseline value. SPSS software,
version 13 was used for data analysis.
Results: Overall, 299 patients were studied.
Thirteen patients (4.3%) developed RCIN. RCIN was 3.3 %
in patients treated with hydration, and 8.3 % in
patients treated with NAC plus hydration (p = 0.09).
In patients with RCIN, the changes in creatinine and
% change in creatinine after 24 h were significantly
lower in the NAC plus hydration group (p = 0.039 and p
= 0.042, respectively). RCIN was significantly
associated with male gender (p = 0.017), history of
renal failure (p = 0.006), ischemic heart disease (p =
0.003), and diuretic treatment (p = 0.013).
Conclusion:
NAC plus saline hydration may not be more effective than
saline hydration alone in decreasing RCIN after coronary
angiography. Additional efforts to find an ideal
preventive treatment are needed.
Keywords: Coronary angiography, N-acetylcysteine,
Radiocontrast-induced nephropathy, Saline hydration.
