Contrast agent nephropathy
Peter Nicol and
Christian Axelson
Department of Medicine, Köping Hospital, Glasgatan 4, 731 81 Köping, SwedenTel.: +46-221-26000; Fax: +46-221-26515
E-mail address: peter.nicol{at}ltvastmanland.se
Dear Sir
The meta-analysis in the Lancet 23 August 20031 concluded that acetylcysteine significantly reduces the risk of contrast nephropathy in patients with chronic renal insufficiency, and that the relative risk of contrast nephropathy was not related to the amount of radio contrast media given. Yet, as we see from a recent issue of the European Heart Journal, doubt seems to remain concerning both questions24. Is it not time to do a large multi-centre trial?
References
- Birck R, Krzossok S, Markowetz F et al. Acetylcysteine for prevention of contrast nephropathy: meta-analysis. Lancet. 2003;362(9384):598603.[CrossRef][Medline]
- Briguori C, Colombo A, Violante A et al. Standard vs double dose of N-acetylcysteine to prevent contrast agent associated nephrotoxicity. Eur. Heart J. 2004;25(3):206211.[Abstract/Free Full Text]
- Goldenberg I, Shechter M, Matetzky S et al. Oral acetylcysteine as an adjunct to saline hydration for the prevention of contrast-induced nephropathy following coronary angiography. A randomized controlled trial and review of the current literature. Eur. Heart J. 2004;25(3):212218.[Abstract/Free Full Text]
- Billinger M, Hess OM, Meier B. Prevention of contrast-induced renal dysfunction by N-acetylcysteine. Truth or myth? Eur. Heart J. 2004;25(3):188189.[Free Full Text]