Table 1

Randomized controlled trials with N-acetylcysteine as a prophylactic measure to prevent contrast-induced nephouropathy
Reference
 Year
 Number of patients
 Reason for contrast administration
 Study design
 Dose/timing/route of administration of NAC
 Hydration regimen
 Main outcomea
[22]
 2000
 83
 CT
 NAC + hydration versus hydration
 600 mg po, twice daily, day before and on day of contrast
 1 ml/kg per hour 0.45% saline 12 hours before – 12 hours after contrast
 RR 0.11 (95% CI 0.02–0.86)
[23]
 2002
 123
 Various
 NAC + hydration versus hydration
 600 mg po, twice daily, day before and on day of contrast
 1 ml/kg per hour 0.45% saline 12 hours before – 12 hours after contrast
 RR 1.18 (95% CI 0.45–3.12)
[24]
 2002
 183
 Various
 NAC + hydration versus hydration
 600 mg po, twice daily, day before and on day of contrast
 1 ml/kg per hour 0.45% saline 12 hours before – 12 hours after contrast
 RR 0.59 (95% CI 0.22–1.57)
[25]
 2002
 54
 CAG
 NAC + hydration versus hydration
 600 mg po, twice daily, day before and on day of contrast
 1 ml/kg per hour 0.45% saline 12 hours before – 12 hours after contrast
 RR 0.18 (95% CI 0.04–0.72)
[26]
 2002
 79
 CAG
 NAC + hydration versus hydration
 1200 mg po, 1 hour before and3 hours after contrast
 1 ml/kg per hour 0.45% saline 12 hours before – 12 hours after contrast
 RR 1.2 (95% CI 0.55–2.63)
[27]
 2002
 121
 CAG
 NAC + hydration versus hydration
 400 mg po, twice daily, day before and on day of contrast
 1 ml/kg per hour 0.45% saline 12 hours before – 12 hours after contrast
 RR 0.14 (95% CI 0.03–0.57)
[28]
 2003
 80
 CAG
 NAC + hydration versus hydration
 150 mg/kg iv, immediately before contrast
 NAC group: 500 ml 0.9% saline before and 500 ml 0.9% saline 4 hours after contrast
 RR 1.20 (95% CI 0.55–2.63)






Control group: 1 ml/kg per hour 0.9% saline 12 hours before – 12 hours after
[29]
 2003
 179
 Elective CAG
 NAC + hydration versus hydration
 600 mg po, twice daily day before and on day of contrast
 75 ml/hour 0.45% saline 12 hours before – 12 hours after contrast
 13% versus 12%; NS
[30]
 2003
 200
 Elective CAG
 NAC + hydration versus hydration
 600 mg po, twice daily, day before and on day of contrast
 1 ml/kg per hour 0.9% saline 12 hours before – 6 hours after contrast
 RR 0.32 (95% CI 0.11–0.96)
[31]
 2003
 108
 CAG
 NAC + hydration versus hydration
 1200 mg iv, 12 hours before and immediately after contrast
 20 ml/hour 5% dextrose 12 hours before – 12 hours after contrast
 3.8% versus 5.9%; NS
[32]
 2003
 43
 Elective CAG
 NAC + hydration versus hydration
 600 mg po, twice daily, day before contrast; and 600 mg po three times daily, day of contrast
 1–2 ml/kg per hour 0.45% saline for 4–12 hours before – 75 ml/hour 0.45% saline for 12 hours after contrast
 4.8% versus 31.8%;P = 0.046
[13]
 2003
 96
 Elective CAG
 NAC + hydration versus hydration
 375 mg po, twice daily, day before and on day of contrast
 1 ml/kg per hour 0.45% saline 12 hours before – 12 hours after contrast
 RR 1.28 (95% CI 0.30–5.41)
[33]
 2004
 223
 Various
 Low-dose versus high-dose NAC
 600 mg po twice daily versus 1200 mg po twice daily, day before and on day of contrast
 1 ml/kg per hour 0.45% saline 12 hours before – 12 hours after contrast
 11% versus 3.5%; P = 0.038
[34]
 2004
 91
 Cardiovascular procedures
 NAC + hydration versus hydration
 400 mg po, three times daily, day before and on day of contrast
 100 ml/hour 0.9% saline 12 hours before – 12 hours after contrast
 17.4% versus 13.3%; NS
[35]
 2004
 80
 CAG
 NAC + hydration versus hydration
 600 mg po, three times daily, day before and on day of contrast
 1 ml/kg per hour 0.45% saline 12 hours before – 12 hours after contrast
 10% versus 8%; NS

aIncidences of contrast-induced nephouropathy. CAG, coronary angiography; CI, confidence interval; CT, computed tomography, iv, intravenously; NAC, N-acetylcysteine; NS, not significant; po, by mouth; RR, relative risk.

van den Berk et al. Critical Care 2005 9:361   doi:10.1186/cc3028