N‐Acetylcysteine in Preventing Contrast‐Induced Nephropathy Assessed by Cystatin C

Alioğlu, Emin; Saygı, Serkan; Türk, Uğur Önsel; Kırılmaz, Bahadır; Tüzün, Nurullah; Duman, Can; Tengiz, İstemihan; Yıldız, Serkan; Ercan, Ertuğrul

doi:10.1111/j.1755-5922.2011.00309.x

Cited by 12 publications

(5 citation statements)

References 37 publications

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“…[ 12 25 ] Supported our results but in rate Abdelrahman et al . [ 26 ] Disagree with our results Nigwekar and Kandula[ 27 ] and Alioglu et al .,[ 28 ] small dose of NAC used in their studies can explain this results. Cystatin C is a low molecular weight protein produced at a constant rate by all nucleated cells.…”

Section: Discussionmentioning

confidence: 91%

Effectiveness of intravenous infusion of N-acetylcysteine in cirrhotic patients undergoing major abdominal surgeries

Ibrahim

Sharawy

2015

Saudi J Anaesth

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Background:Postoperative acute kidney injury (AKI) is common in patients with chronic liver disease. We prospectively evaluated effectiveness of the N-acetylcysteine (NAC) in preserving postoperative renal functions in cirrhotic patients undergoing major abdominal surgeries.Materials and Methods:A total of 60 cirrhotic patients child A to B were randomized into two groups of 30 each. NAC groupwas received intravenous infusion of NAC (1200 mg/12h starting immediately before surgery and continued for 72h h postoperative) and controls group received a similar volume of glucose 5% solution as a a placebo. Systemic hemodynamics, hepatic and renal functions, serum cystatin C and cystatin C glomerular filtration rate (GFR) (GFR) were compared between both groups.Results:Serum level of cystatin C was raised significantly above the basal value at postoperative day 1 and day 3 associated with significantly decreased in cystatin C GFR below the basal value in the control group (P = 0.001). 6 (20%) (PP = 0.03) in control group developed AKI based on cystatin C GFR criteria (GFR <55 ml/min/1.73m2). Mean values of alanine aminotransferase and aspartate aminotransferase were increased significantly above the basal values in both groups, but the increases were significantly lower in NAC group (P = 0.00). Chest infection was significantly lower associated with shorter hospital stay in the NAC group than the control group.Conclusion:Intravenous administration of NAC NAC in cirrhotic patients undergoing major abdominal surgeries reduces the incidence of cystatin C GFR-based AKI, postoperative renal and liver functions were well-preserved and improved outcome.

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Section: Discussionmentioning

confidence: 91%

Effectiveness of intravenous infusion of N-acetylcysteine in cirrhotic patients undergoing major abdominal surgeries

Ibrahim

Sharawy

2015

Saudi J Anaesth

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“…One might argue that creatinine may not be a sensitive index of glomerular filtration rate (GFR) alterations [ 31 ]. Previous studies suggested that creatinine metabolism can be affected by Nac, so that the observed changes in serum creatinine concentration after administration of Nac may not be indicative of GFR improvement [ 32 ]. In order to overcome these obstacles we assessed sCysC concentration, which can serve as an endogenous marker of renal function and is believed to be superior to plasma creatinine concentration as it does not depend on age, sex and muscle mass, and so it has been considered as a simple, reliable and accurate marker of renal function [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

The impact of N-acetylcysteine and ascorbic acid in contrast-induced nephropathy in critical care patients: an open-label randomized controlled study

et al. 2017

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BackgroundThe aim was to investigate whether the use of N-acetylcysteine and ascorbic acid reduce contrast-induced nephropathy incidence in critical care patients.MethodsThis was a one-center, two-arm, prospective, randomized, open-label, controlled trial in the Intensive Care Unit of the University Hospital of Larissa, Greece. Patients with stable renal function, who underwent non urgent contrast-enhanced computed tomography for diagnostic purposes, were included in the study. Patients in the treatment group (NacA, n = 60) received intravenously N-acetylcysteine (1200 mg) and ascorbic acid (2 g) dissolved separately in 100 ml of normal saline 2 hours before, and at 10 hours and 18 hours following the infusion of contrast agent, while control group patients (CG, n = 64) received only normal saline. All patients received additional hydration. Contrast-induced nephropathy was defined as relative increase by 25% of the baseline values of serum creatinine.ResultsContrast-induced nephropathy in NacA and CG were 18.33% and 15.6%, respectively (p = 0.81). The percentage change median (interquartile range (IR)) of serum cystatin-C (mg/L) from baseline in patients who underwent contrast-induced tomography, were 37.23% (28.53) and 93.20% (46.90) in NacA and in CG, respectively (p = 0.03). The 8-isoprostane serum levels in NacA were significantly lower compared to CG at 2 hours (p = 0.012) and 24 hours (p = 0.006) following radiocontrast infusion. Multivariate analysis revealed that contrast-induced nephropathy was independently associated with a higher baseline ratio of serum urea/creatinine (odds ratio, 1.02; 95 CI%, 1.00–1.05) and with the use of nephrotoxic medications (odds ratio, 0.24; 95 CI%, 0.06–0.94).ConclusionIntravenous administration of N-acetylcysteine and ascorbic acid failed to reduce contrast-induced nephropathy in critically ill patients who underwent contrast-enhanced computed tomography, despite a significant reduction of 8-isoprostane levels in treated patients.Trial registrationClinicalTrials.gov, NCT01017796. Registered on 20 November 2009.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-017-1862-3) contains supplementary material, which is available to authorized users.

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“…In this study, unlike other experimental studies, novel acute kidney injury marker cystatin C was used to diagnose CIN. Cystatin C is a reliable marker for early diagnosis and prognosis of contrast- induced acute kidney injury in humans (14, 15). Consequently, the present study showed that cystatin C is a sensitive parameter for detecting acute renal injury in rats due to contrast.…”

Section: Discussionmentioning

confidence: 99%

The protective effect of single dose tadalafil in contrast-induced nephropathy: An experimental study

Özbek¹,

Ceyhan²,

Koç³

et al. 2015

Anatol J Cardiol

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Objective:Contrast-induced nephropathy (CIN) is one of the most common causes of acute renal failure in hospitalized patients. The direct toxic effect of contrast media; ischemic damage caused by reactive oxygen species; increased perivascular hydrostatic pressure; high viscosity and changes in the activity of vasoactive substances play important roles in the pathogenesis. Tadalafil inhibits the phosphodiesterase enzyme which destroys nitric oxide. Nitric oxide causes renal vasodilatation, increases renal medullar blood flow and mediates the removal of free oxygen radicals. Drugs that increase levels of nitric oxide are expected to reduce the development of contrast nephropathy due to contrast media. We aimed to test the hypothesis that tadalafil reduces the development of contrast nephropathy due to contrast toxicity.Methods:A total of 24 female Wistar albino rats, three groups of eight, were included in the study. After 48 hours of dehydration, contrast media (meglumine diatrozoate, 6 mL/kg) was administered to the first group, and contrast media with tadalafil (10 mg/kg) was administered to the second group. The third group served as the control group. Blood and tissue samples were taken 48 hours after this procedure.Results:Serum cystatin C, serum creatinine and blood urea nitrogen (BUN) values were significantly lower in the contrast with tadalafil group compared to the group given only contrast. Serum and tissue malondialdehyde (MDA) levels were significantly lower in the contrast with tadalafil group than in the contrast only group.Conclusion:These results demonstrate the protective effect of tadalafil in the prevention of CIN in rats.

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N‐Acetylcysteine in Preventing Contrast‐Induced Nephropathy Assessed by Cystatin C

Cited by 12 publications

References 37 publications

Effectiveness of intravenous infusion of N-acetylcysteine in cirrhotic patients undergoing major abdominal surgeries

Effectiveness of intravenous infusion of N-acetylcysteine in cirrhotic patients undergoing major abdominal surgeries

The impact of N-acetylcysteine and ascorbic acid in contrast-induced nephropathy in critical care patients: an open-label randomized controlled study

The protective effect of single dose tadalafil in contrast-induced nephropathy: An experimental study

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