Prevention of contrast-induced nephropathy: a single center randomized study

Clin Cardiol. 2010 Mar;33(3):E63-8. doi: 10.1002/clc.20576.


Background: Contrast-induced nephropathy (CIN) is the third cause of acute deterioration of renal function in hospitalized patients.

Hypothesis: The purpose of the study was to compare the efficacy of saline infusion, saline infusion plus N-acetylcysteine (NAC), and sodium bicarbonate (SB) infusion to prevent CIN in patients undergoing coronary angiography and/or percutaneous coronary intervention.

Methods: We prospectively studied 156 patients with a baseline creatinine level > or = 1.2 mg/dL. The primary endpoint was the development of CIN, defined as an increase in serum creatinine concentration > or = 25% over the baseline value within 5 days from contrast exposure.

Results: Contrast-induced nephropathy developed in 23 patients (14.7%). Incidence of the primary endpoint was similar in the 3 groups of treatment, occurring in 7 patients (14%) in the saline infusion group, in 9 (17%) in the saline infusion plus NAC group, and in 7 (14%) in the SB infusion group.

Conclusions: Our findings suggest that neither the addition of NAC nor the administration of SB add further benefit in CIN prevention, compared to standard hydration with isotonic saline infusion.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine / administration & dosage
  • Acetylcysteine / therapeutic use*
  • Acute Disease
  • Aged
  • Angioplasty, Balloon, Coronary / methods
  • Contrast Media / adverse effects*
  • Coronary Angiography / methods
  • Female
  • Free Radical Scavengers / administration & dosage
  • Free Radical Scavengers / therapeutic use*
  • Glomerular Filtration Rate
  • Humans
  • Incidence
  • Kidney Diseases / chemically induced
  • Kidney Diseases / prevention & control*
  • Male
  • Prospective Studies
  • Sodium Bicarbonate / administration & dosage
  • Sodium Bicarbonate / therapeutic use*
  • Sodium Chloride / administration & dosage
  • Sodium Chloride / therapeutic use*


  • Contrast Media
  • Free Radical Scavengers
  • Sodium Chloride
  • Sodium Bicarbonate
  • Acetylcysteine