Objectives: To evaluate the effect of reduced glutathione on renal outcomes following the selective coronary angiography and/or intervention.
Background: Contrast agents can cause an acute reduction in renal function that may be due to the generation of reactive oxygen species. The role of antioxidants in prevention of this renal impairment is controversial.
Methods and results: We conducted a randomized, placebo-controlled trial of reduced glutathione in 825 patients who underwent selective coronary angiography and/or intervention. Patients were assigned to reduced glutathione 1800 mg (n = 416) or placebo (n = 411) intravenously. Contrast-induced acute kidney injury was defined by an absolute increase of serum creatinine ≥0.5 mg/dl (44.2 μmol/L) or a relative increase of ≥25% measured 48 hours after the procedure. The incidence of contrast-induced acute kidney injury was 5.07% in the glutathione group and 4.97% in the control group (relative risk, 1.04; 95% confidence interval, 0.59-1.83; P = 0.886). Change in serum malondialdehyde was (-) 1.01 ± 1.69 nmol/ml in the glutathione group and (-) 0.67 ± 1.55 nmol/ml in the control group (P = 0.054), and change in serum total antioxidant capacity level was also similar in both groups (0.91 ± 2.06 nmol/ml and 0.79 ± 2.18 nmol/ml, respectively; P = 0.936).
Conclusions: A single dose of reduced glutathione does not reduce the risk of contrast-induced acute kidney injury in patients undergoing coronary angiography and/or intervention.
© 2015, Wiley Periodicals, Inc.