Prospective randomized study of N‐acetylcysteine, fenoldopam, and saline for prevention of radiocontrast‐induced nephropathy

Catheterization and Cardiovascular Interventions - Tập 57 Số 3 - Trang 279-283 - 2002
Suhail Allaqaband1, Ramagopal Tumuluri2, Ahmed M. Malik3, Anjan Gupta2, PAUL VOLKERT2, Yoseph Shalev2, Tanvir Bajwa2
1Department of Cardiology, University of Wisconsin Medical School, Milwaukee Clinical Campus, Aurora-Sinai Medical Center, Milwaukee, Wisconsin 53201, USA.
2Department of Cardiology, University of Wisconsin Medical School, Milwaukee Clinical Campus, Aurora-Sinai Medical Center, Milwaukee, Wisconsin
3Department of Internal Medicine, University of Wisconsin Medical School, Milwaukee Clinical Campus, Aurora-Sinai Medical Center, Milwaukee, Wisconsin

Tóm tắt

AbstractThe objective of this study was to compare the efficacy of N‐acetylcysteine (NAC), fenoldopam, and saline in preventing radiocontrast‐induced nephropathy (RCIN) in high‐risk patients undergoing cardiovascular procedures. We prospectively enrolled 123 patients who were scheduled for cardiovascular procedures and had a baseline creatinine > 1.6 mg/dl or creatinine clearance of < 60 ml/min. Patients were randomly assigned to receive either saline (0.45% normal saline at 1 cc/kg) for 12 hr before and 12 hr after the procedure, or fenoldopam (0.1 μg/kg/min) plus saline for 4 hr prior and 4 hr after the procedure, or NAC orally (600 mg) plus saline every 12 hr for 24 hr prior and 24 hr after the procedure. All the patients received low‐osmolality nonionic contrast. RCIN was defined as an increase in creatinine level > 0.5 mg/dl after 48 hr. The incidence of RCIN was 17.7% in the NAC group, 15.3% in the saline group, and 15.7% in the fenoldopam group (P = 0.919). Of the 20 patients who developed RCIN, 2 required dialysis. Serum creatinine decreased after 48 hr (vs. baseline) in 38% patients in the NAC group, 18% in the fenoldopam group, and 15% in the saline group. In patients with chronic renal insufficiency, NAC or fenoldopam offered no additional benefit over hydration with saline in preventing RCIN. Cathet Cardiovasc Intervent 2002;57:279–283. © 2002 Wiley‐Liss, Inc.

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Thông tin
Thông tin xuất bản

Catheterization and Cardiovascular Interventions

Tập 57 Số 3

279-283

Thông tin tác giả