 |
||||
| 2007 JASN IMPACT FACTOR 7.111 | HOME AUTHOR INFO EDITORIAL BOARD SUBSCRIBE FEEDBACK ALERTS HELP | |||
| CURRENT ISSUE | ARCHIVES | JASN Express | ONLINE SUBMISSION | |
|
||||
| 2007 JASN IMPACT FACTOR 7.111 | HOME AUTHOR INFO EDITORIAL BOARD SUBSCRIBE FEEDBACK ALERTS HELP | |||
| CURRENT ISSUE | ARCHIVES | JASN Express | ONLINE SUBMISSION | |
REVIEW |
*Winthrop-University Hospital, Mineola, New York; Orangeburg Nephrology Associates, Orangeburg, South Carolina; University of Pennsylvania, Philadelphia, Pennsylvania.
Correspondence to Dr. Steven Fishbane, 200 Old Country Road, #135, Mineola, NY 11501. Phone: 516-663-2169; Fax: 516-663-2179; E-mail: sfishbane{at}winthrop.org
N-acetylcysteine is a remarkably active agent shown to be useful in a variety of clinical settings. The drug has actions relevant to radiocontrast-induced nephropathy (RCIN) that include vasodilatation, enhancement of renal medullary blood flow, and antioxidant properties. The drug’s pharmacokinetics are remarkable for almost complete first pass metabolism after oral administration, resulting in no free drug reaching the circulation. After intravenous administration, extensive reaction with tissue and plasma proteins greatly limits the amount of circulating free drug. Given the difficulty achieving free drug in the systemic circulation, it is highly likely that the drug works via its metabolites. The primary mechanism may be through L-cysteine as a cellular source for glutathione production. Clinical studies of N-acetylcysteine in the prevention of RCIN have yielded highly mixed results; five were dramatically positive, and eight others had no demonstrable efficacy at all. The following will review the individual studies, attempt to reconcile the divergent results, and propose future research needs.
This article has been cited by other articles:
 |
|
 |
|
  M. Maioli, A. Toso, M. Leoncini, M. Gallopin, D. Tedeschi, C. Micheletti, and F. Bellandi Sodium Bicarbonate Versus Saline for the Prevention of Contrast-Induced Nephropathy in Patients With Renal Dysfunction Undergoing Coronary Angiography or Intervention J. Am. Coll. Cardiol., August 19, 2008; 52(8): 599 - 604. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Alipour, A. Omri, M. G. Smith, and Z. E. Suntres Prophylactic effect of liposomal N-acetylcysteine against LPS-induced liver injuries Innate Immunity, October 1, 2007; 13(5): 297 - 304. [Abstract] [PDF]
|
|
|
|
 |
|
 G. T. C. Wong and M. G. Irwin Contrast-induced nephropathy Br. J. Anaesth., October 1, 2007; 99(4): 474 - 483. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. W H Fung, C. C Szeto, and C. M Yu Preventing contrast nephropathy in catheter laboratory Heart, June 1, 2007; 93(6): 654 - 655. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Recio-Mayoral, M. Chaparro, B. Prado, R. Cozar, I. Mendez, D. Banerjee, J. C. Kaski, J. Cubero, and J. M. Cruz The Reno-Protective Effect of Hydration With Sodium Bicarbonate Plus N-Acetylcysteine in Patients Undergoing Emergency Percutaneous Coronary Intervention: The RENO Study J. Am. Coll. Cardiol., March 27, 2007; 49(12): 1283 - 1288. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Schmidt, D. Pang, D. Nykamp, G. Knowlton, and H. Jia N-Acetylcysteine and Sodium Bicarbonate Versus N-Acetylcysteine and Standard Hydration for the Prevention of Radiocontrast-Induced Nephropathy Following Coronary Angiography Ann. Pharmacother., January 1, 2007; 41(1): 46 - 50. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. R. Taylor, J. Reidy, and J. E. Scoble Endovascular abdominal aortic aneurysm repair and renal function Nephrol. Dial. Transplant., September 1, 2006; 21(9): 2362 - 2365. [Full Text] [PDF]
|
|
|
|
|
|
B. Dussol, S. Morange, A. Loundoun, P. Auquier, and Y. Berland A randomized trial of saline hydration to prevent contrast nephropathy in chronic renal failure patients Nephrol. Dial. Transplant., August 1, 2006; 21(8): 2120 - 2126. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Tepel, P. Aspelin, and N. Lameire Contrast-Induced Nephropathy: A Clinical and Evidence-Based Approach Circulation, April 11, 2006; 113(14): 1799 - 1806. [Full Text] [PDF]
|
|
|
|
 |
|
 B. J. Barrett and P. S. Parfrey Preventing Nephropathy Induced by Contrast Medium N. Engl. J. Med., January 26, 2006; 354(4): 379 - 386. [Full Text] [PDF]
|
|
|
|
|
|
S J Shalansky, G E Pate, A Levin, and J G Webb N-acetylcysteine for prevention of radiocontrast induced nephrotoxicity: the importance of dose and route of administration Heart, August 1, 2005; 91(8): 997 - 999. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Goldenberg and S. Matetzky Nephropathy induced by contrast media: pathogenesis, risk factors and preventive strategies Can. Med. Assoc. J., May 24, 2005; 172(11): 1461 - 1471. [Abstract] [Full Text] [PDF]
|
|
|
HOME
CURRENT ISSUE
ARCHIVES
JASN Express
ONLINE SUBMISSION
AUTHOR INFO
EDITORIAL BOARD SUBSCRIBE FEEDBACK ALERTS HELP |
Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673
