Intravenous High Dose NAC and Sodium Bicarbonate for the Prevention of Contrast-induced Acute Injury

Intravenous High Dose of N-acetylcysteine and Sodium Bicarbonate for the Prevention of Contrast-induced Acute Injury: a Randomized Controlled Trial

Contrast-induced acute kidney injury is a common cause of acquired in-hospital renal insufficiency and is associated with prolonged hospitalization and unfavorable early and late outcomes. The investigators sought to compare 4 different strategies (intravenous high-dose of N-acetylcysteine, sodium bicarbonate, the combination of both, and saline alone) in the prevention of contrast-induced acute kidney injury in patients undergoing coronary angiography using high-osmolar contrast media defined by creatinine and cystatin C serum levels.

Inclusion Criteria:

• eligible patients include individuals aged 18 year or older with normal renal function who were schedule to undergo cardiac catheterization. During the randomized study, consecutive eligible patients schedule for exposure to the ionic, high osmolality (2130 mOsm/Kg) contrast agent Ioxitalamato.

Exclusion Criteria:

• using metformin or nonsteroidal antiinflammatory drugs within the previous 48 hours
• intake of nephrotoxic drugs during the previous seven days
• pregnancy
• lactation
• intravascular administration of an iodinated contrast medium within the previous two days
• emergency catheterization
• pulmonary edema
• acutely decompensate congestive heart failure
• history of serious reactions to iodinated contrast mediums
• renal transplantation
• end-stage renal disease necessitating dialysis