Background: Contrast-induced acute kidney injury (CI-AKI) is one of the possible complications
in angiography, which its prevention is important. N-acetylcysteine is one of the compounds
that has recently been more investigated regarding its effect on CI-AKI.
Objectives: The aim of this study was to investigate the effect of standard dose and twice-thestandard
of N-acetyl cysteine on prevention of contrast-induced nephropathy.
Patients and Methods: In a clinical trial, 154 individuals who were referred for angiography and
had glomerular filtration rate (GFR) ≤60 mL/min, enrolled in and randomly divided into two
groups. Group A received the usual dose of N-acetyl cysteine and group B received twice
the standard. Blood urea nitrogen (BUN), creatinine, and GFR values were measured and
recorded at intervals before, 24, 48 and 72 hours after angiography. Other required laboratory
parameters were also measured and recorded.
Results: The results of this study indicated that the effect of double dose in males and females
is not different. It also has a reverse effect on renal function in older patients. Its effect did
not differ in diabetic patients compared to non-diabetic patients. N-acetyl cysteine in dose
of twice the standard has not any effect on renal function in patients with hyperlipidemia,
hypertension, myocardial infarction, pulmonary edema as well as smoker patients. In patients
with congestive heart failure (CHF), N-acetyl cysteine in dose of twice the standard had a
positive effect on renal function compared with those who did not have CHF. An interesting
point in our study was the negative effect of N-acetyl cysteine in dose of twice-the-standard on
renal function in patients with lower hemoglobin and hematocrit levels.
Conclusions: Our study showed that an increase in the dose of N-acetyl cysteine is not effective
in preventing contrast-induced nephropathy and improving renal function. Of course, in some
groups, such as those with CHF, a positive effect was detected. Additionally, in some groups
including patients with lower hematocrit and hemoglobin, an increase in dose is associated
with a negative effect on renal function.