N-acetylcysteine for the prevention of contrast-induced nephropathy in patients with pre-existing renal insufficiency or diabetes: a systematic review and meta-analysis

What this study found

NAC reduced the incidence of contrast-induced nephropathy in patients with pre-existing renal insufficiency, but it did not show a protective effect in patients with diabetes. In the renal insufficiency subgroup, pooled OR was 0.76 (95% CI 0.61-0.93; p=0.008), and the intravenous subgroup showed benefit with OR 0.67 (95% CI 0.50-0.90; p=0.008), while oral NAC was not significant (OR 0.85, 95% CI 0.64-1.13; p=0.26). In the diabetes subgroup, pooled OR was 0.87 (95% CI 0.58-1.30; p=0.50), with no significant benefit for either intravenous or oral NAC. CIN was defined as a serum creatinine…

Study & population

Systematic review and meta-analysis of 21 randomized trials in adults undergoing contrast exposure with pre-existing renal insufficiency or diabetes mellitus.

Intervention

N-acetylcysteine (NAC) was evaluated as prophylaxis before contrast exposure, given either intravenously or orally across the included trials.

Key limitation

Dosing, route, and treatment schedules varied substantially across trials, which may have contributed to heterogeneity.

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