30 Citations (Scopus)

Abstract

Background: N-Acetylcysteine (NAC) is reported to have potential for preventing of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography. However, the effectiveness of NAC in preventing CIN in patients undergoing contrast-enhanced computed tomography (CT) is still controversial. We conducted a meta-analysis of relevant randomized controlled trials (RCTs) to further examine this issue. Methods: RCTs were identified by computerized searching in PubMed, EMBASE, SCOPUS, and Cochrane databases. Two reviewers independently assessed the methodological quality of each study. A meta-analysis was performed to evaluate the effectiveness of NAC in preventing CIN in patients undergoing CT. The primary outcome was the incidence of contrast-induced nephropathy, and the requirement for dialysis. The secondary outcome was the change of serum creatinine. Results: Six randomized controlled trials were identified with a total of 496 patients meeting the criteria for this study. Prophylactic administration of NAC in patients with serum creatinine above 1.2 mg/dL undergoing contrast-enhanced CT, along with hydration, reduced the risk of CIN (relative risk 0.20; 95 % confidence interval: 0.07-0.57). Requirement for dialysis was not significantly different between the NAC group and the control group. Conclusions: This review provides evidence of the efficacy of NAC in preventing the incidence of CIN and recommends that NAC be more widely used in high-risk patients undergoing contrast-enhanced CT. On the basis of the evidence reviewed, further research involving large RCTs may be warranted.

Original languageEnglish
Pages (from-to)1309-1318
Number of pages10
JournalInternational Urology and Nephrology
Volume45
Issue number5
DOIs
Publication statusPublished - Oct 2013

Fingerprint

Acetylcysteine
Meta-Analysis
Randomized Controlled Trials
Tomography
Dialysis
Creatinine
Incidence
Coronary Angiography
Serum
PubMed
Databases
Confidence Intervals
Control Groups
Research

Keywords

  • Computed tomography
  • Contrast-induced nephropathy
  • Meta-analysis
  • N-Acetylcysteine

ASJC Scopus subject areas

  • Nephrology
  • Urology

Cite this

@article{97c7b785fc274051a9829e1221516551,
title = "The effectiveness of N-acetylcysteine in preventing contrast-induced nephropathy in patients undergoing contrast-enhanced computed tomography: A meta-analysis of randomized controlled trials",
abstract = "Background: N-Acetylcysteine (NAC) is reported to have potential for preventing of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography. However, the effectiveness of NAC in preventing CIN in patients undergoing contrast-enhanced computed tomography (CT) is still controversial. We conducted a meta-analysis of relevant randomized controlled trials (RCTs) to further examine this issue. Methods: RCTs were identified by computerized searching in PubMed, EMBASE, SCOPUS, and Cochrane databases. Two reviewers independently assessed the methodological quality of each study. A meta-analysis was performed to evaluate the effectiveness of NAC in preventing CIN in patients undergoing CT. The primary outcome was the incidence of contrast-induced nephropathy, and the requirement for dialysis. The secondary outcome was the change of serum creatinine. Results: Six randomized controlled trials were identified with a total of 496 patients meeting the criteria for this study. Prophylactic administration of NAC in patients with serum creatinine above 1.2 mg/dL undergoing contrast-enhanced CT, along with hydration, reduced the risk of CIN (relative risk 0.20; 95 {\%} confidence interval: 0.07-0.57). Requirement for dialysis was not significantly different between the NAC group and the control group. Conclusions: This review provides evidence of the efficacy of NAC in preventing the incidence of CIN and recommends that NAC be more widely used in high-risk patients undergoing contrast-enhanced CT. On the basis of the evidence reviewed, further research involving large RCTs may be warranted.",
keywords = "Computed tomography, Contrast-induced nephropathy, Meta-analysis, N-Acetylcysteine",
author = "Mei-Yi Wu and Hsiang, {Hui Fen} and Wong, {Chung Shun} and Yao, {Min Szu} and Li, {Yun Wen} and Hsiang, {Chao Ying} and Chyi-Huey Bai and Yung-Ho Hsu and Yuh-Feng Lin and Ka-Wai Tam",
year = "2013",
month = "10",
doi = "10.1007/s11255-012-0363-1",
language = "English",
volume = "45",
pages = "1309--1318",
journal = "International Urology and Nephrology",
issn = "0301-1623",
publisher = "Springer Netherlands",
number = "5",

}

TY - JOUR

T1 - The effectiveness of N-acetylcysteine in preventing contrast-induced nephropathy in patients undergoing contrast-enhanced computed tomography

T2 - A meta-analysis of randomized controlled trials

AU - Wu, Mei-Yi

AU - Hsiang, Hui Fen

AU - Wong, Chung Shun

AU - Yao, Min Szu

AU - Li, Yun Wen

AU - Hsiang, Chao Ying

AU - Bai, Chyi-Huey

AU - Hsu, Yung-Ho

AU - Lin, Yuh-Feng

AU - Tam, Ka-Wai

PY - 2013/10

Y1 - 2013/10

N2 - Background: N-Acetylcysteine (NAC) is reported to have potential for preventing of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography. However, the effectiveness of NAC in preventing CIN in patients undergoing contrast-enhanced computed tomography (CT) is still controversial. We conducted a meta-analysis of relevant randomized controlled trials (RCTs) to further examine this issue. Methods: RCTs were identified by computerized searching in PubMed, EMBASE, SCOPUS, and Cochrane databases. Two reviewers independently assessed the methodological quality of each study. A meta-analysis was performed to evaluate the effectiveness of NAC in preventing CIN in patients undergoing CT. The primary outcome was the incidence of contrast-induced nephropathy, and the requirement for dialysis. The secondary outcome was the change of serum creatinine. Results: Six randomized controlled trials were identified with a total of 496 patients meeting the criteria for this study. Prophylactic administration of NAC in patients with serum creatinine above 1.2 mg/dL undergoing contrast-enhanced CT, along with hydration, reduced the risk of CIN (relative risk 0.20; 95 % confidence interval: 0.07-0.57). Requirement for dialysis was not significantly different between the NAC group and the control group. Conclusions: This review provides evidence of the efficacy of NAC in preventing the incidence of CIN and recommends that NAC be more widely used in high-risk patients undergoing contrast-enhanced CT. On the basis of the evidence reviewed, further research involving large RCTs may be warranted.

AB - Background: N-Acetylcysteine (NAC) is reported to have potential for preventing of contrast-induced nephropathy (CIN) in patients undergoing coronary angiography. However, the effectiveness of NAC in preventing CIN in patients undergoing contrast-enhanced computed tomography (CT) is still controversial. We conducted a meta-analysis of relevant randomized controlled trials (RCTs) to further examine this issue. Methods: RCTs were identified by computerized searching in PubMed, EMBASE, SCOPUS, and Cochrane databases. Two reviewers independently assessed the methodological quality of each study. A meta-analysis was performed to evaluate the effectiveness of NAC in preventing CIN in patients undergoing CT. The primary outcome was the incidence of contrast-induced nephropathy, and the requirement for dialysis. The secondary outcome was the change of serum creatinine. Results: Six randomized controlled trials were identified with a total of 496 patients meeting the criteria for this study. Prophylactic administration of NAC in patients with serum creatinine above 1.2 mg/dL undergoing contrast-enhanced CT, along with hydration, reduced the risk of CIN (relative risk 0.20; 95 % confidence interval: 0.07-0.57). Requirement for dialysis was not significantly different between the NAC group and the control group. Conclusions: This review provides evidence of the efficacy of NAC in preventing the incidence of CIN and recommends that NAC be more widely used in high-risk patients undergoing contrast-enhanced CT. On the basis of the evidence reviewed, further research involving large RCTs may be warranted.

KW - Computed tomography

KW - Contrast-induced nephropathy

KW - Meta-analysis

KW - N-Acetylcysteine

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U2 - 10.1007/s11255-012-0363-1

DO - 10.1007/s11255-012-0363-1

M3 - Article

VL - 45

SP - 1309

EP - 1318

JO - International Urology and Nephrology

JF - International Urology and Nephrology

SN - 0301-1623

IS - 5

ER -