Contrast media infusion generates reactive oxygen species that causes renal injury. NAC administration would bind the circulating free radicals and inhibit their ability to damage renal tissues. Another mechanism for renal prevention is binding of NAC with nitric oxide to form S-nitrosothiol, a potent vasodilator that would increase renal perfusion.
In this study, patients were assigned to receive standard dose NAC, high dose NAC or placebo. Patients in standard dose group received 600 mg 12 hours before and twice daily for the 48 hours after intervention. Patient in high dose group received 1200 mg of NAC before and after intervention. Patients were also given saline at rate of 1 ml/kg/hr for 12 hours. Prophylactic treatment with NAC reduced the rate of contrast medium induced nephropathy compared to saline hydration alone. High dose of NAC was more beneficial than the standard dose that suggests a dose dependent effect.
Posted by Prabhdeep Sidhu, PharmD Candidate 2015