Does Oral N-Acetylcysteine Reduce Contrast-Induced Renal Injury in Patients With Peripheral Arterial Disease Undergoing Peripheral Angiography? A Randomized-Controlled Study

The nephroprotective role of N-acetylcysteine (NAC) against contrast-induced nephropathy (CIN) in patients undergoing peripheral arterial angiography remains unclear. A total of 40 patients undergoing peripheral arterial angiography were randomized to receive intravenous (iv) hydration only (group 1) or oral NAC in addition to iv hydration (group 2; ISRCTN: 35882618). Primary outcome was reduction in the elevation of urinary retinol binding protein (RBP), albumin—creatinine ratio (ACR), and serum creatinine (serC). Groups 1 and 2 had equivocal percentage reduction in RBP and ACR levels from baseline (P = .80 and .30). A significant reduction in serC was, however, observed with NAC by third postprocedure day (P = .04). One patient in the treatment arm developed CIN compared with 3 patients in the control group (P = .33). Equivocal changes in RBP and ACR levels by both treatments seem to indicate that either is equally effective in affording renal protection.