N-acetylcysteine in the prevention of contrast-induced nephropathy

Background and objectives: Contrast-induced nephropathy (CIN) is a common clinical problem that is growing in importance as an increasing number of tests and procedures that utilize contrast media are performed. Design, setting, participants, and measurements: The biological and pharmacological properties of n-acetylcysteine (NAC) are reviewed, as well as the current literature relevant to the ability of NAC to prevent CIN. Results: After publication of a seminal study by Tepel et al. in 2000, there has been a surge in interest regarding the ability of NAC to reduce the risk for CIN. Since then a large number of studies, mostly with relatively small sample sizes, have been published. Conclusions: The results have been remarkably varied with some studies finding great efficacy with NAC but most finding no significant benefit.