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

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 sodiumbicarbonate (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 ≥1.2mg/dL. The primary endpoint was the development of CIN, defined as an increase in serum creatinine concentration ≥25% over the baseline value within 5 days fromcontrast 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.