I.v. N-acetylcysteine and emergency CT: use of serum creatinine and cystatin C as markers of radiocontrast nephrotoxicity

Autor: Alexandra Platon, Bernadette Mermillod, Christoph R. Becker, Bernard Vermeulen, Pierre-Alexandre Alois Poletti, François Sarasin, Anna Maria Sautter, Patrick Saudan, Pierre-Yves Martin
Rok vydání: 2007
Předmět:
Cystatins/blood
Male
Emergency Medical Services
Contrast Media
Injections
Intravenous/adverse effects
urologic and male genital diseases
Acetylcysteine
chemistry.chemical_compound
Biological Markers/blood
ddc:616
biology
ddc:617
General Medicine
Acute Kidney Injury
Treatment Outcome
Creatinine
Toxicity
Injections
Intravenous
Female
medicine.drug
Adult
medicine.medical_specialty
Iohexol
Urology
Renal function
ddc:616.0757
Nephrotoxicity
medicine
Humans
Radiology
Nuclear Medicine and imaging
Contrast Media/adverse effects
Iohexol/adverse effects/analogs & derivatives/diagnostic use
Cystatin C
ddc:613
business.industry
Emergency Medical Services/methods
Tomography
X-Ray Computed/adverse effects
Creatinine/blood
medicine.disease
Cystatins
Surgery
Contrast medium
chemistry
Acute Kidney Injury/blood/chemically induced/prevention & control
biology.protein
Acetylcysteine/administration & dosage
business
Tomography
X-Ray Computed
Biomarkers
Kidney disease
Zdroj: American Journal of Roentgenology, Vol. 189, No 3 (2007) pp. 687-92
ISSN: 1546-3141
0361-803X
Popis: The purpose of this study was to assess the effect of i.v. administration of N-acetylcysteine (NAC) on serum levels of creatinine and cystatin C, two markers of renal function, in patients with renal insufficiency who undergo emergency contrast-enhanced CT.Eighty-seven adult patients with renal insufficiency who underwent emergency CT were randomized to two groups. In the first group, in addition to hydration, patients received a 900-mg injection of NAC 1 hour before and another immediately after injection of iodine contrast medium. Patients in the second group received hydration only. Serum levels of creatinine and cystatin C were measured at admission and on days 2 and 4 after CT. Nephrotoxicity was defined as a 25% or greater increase in serum creatinine or cystatin C concentration from baseline value.A 25% or greater increase in serum creatinine concentration was found in nine (21%) of 43 patients in the control group and in two (5%) of 44 patients in the NAC group (p = 0.026). A 25% or greater increase in serum cystatin C concentration was found in nine (22%) of 40 patients in the control group and in seven (17%) of 41 patients in the NAC group (p = 0.59).On the basis of serum creatinine concentration only, i.v. administration of NAC appears protective against the nephrotoxicity of contrast medium. No effect is found when serum cystatin C concentration is used to assess renal function. The effect of NAC on serum creatinine level remains unclear and may not be related to a renoprotective action.
Databáze: OpenAIRE
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