Prospective randomized study of N-acetylcysteine, fenoldopam, and saline for prevention of radiocontrast-induced nephropathy
Prospective randomized study of N-acetylcysteine, fenoldopam, and saline for prevention of radiocontrast-induced nephropathy
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DOI：
10.1002/ccd.10323
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发表时间：
2002-11-01
影响因子：
2.3
通讯作者：
Bajwa, TK
中科院分区：
文献类型：
--
作者：
Allaqaband, S;Tumuluri, R;Bajwa, TK
本研究的目的是比较N-乙酰半胱氨酸(NAG)、非诺多巴和生理盐水预防接受心血管手术的高危患者中放射性造影剂诱导的肾病(RCIN)的效果。我们前瞻性地招募了123名计划进行心血管手术的患者，他们在48小时后肌酐水平为1.6 mg/dl或肌酐清除量为0.5 mg/dl。肾癌发生率NAC组为17.7%，生理盐水组为15.3%，非诺多巴组为15.7%(P=0.919)。发生RCIN的20例患者中，2例需要透析。48小时后(与基线相比)，NAC组、非诺多巴组和生理盐水组分别有38%、18%和15%的患者血肌酐下降。在慢性肾功能不全患者中，NAC或非诺多巴在预防RCIN方面没有提供比生理盐水水化更多的好处。
The objective of this study was to compare the efficacy of N-acetylcysteine (NAG), fenoldopam, and saline in preventing radiocontrast-induced nephropathy (RCIN) in high-risk patients undergoing cardiovascular procedures. We prospectively enrolled 123 patients who were scheduled for cardiovascular procedures and had a baseline creatinine >1.6 mg/dl or creatinine clearance of 0.5 mg/dl after 48 hr. The incidence of RCIN was 17.7% in the NAC group, 15.3% in the saline group, and 15.7% in the fenoldopam group (P = 0.919). Of the 20 patients who developed RCIN, 2 required dialysis. Serum creatinine decreased after 48 hr (vs. baseline) in 38% patients in the NAC group, 18% in the fenoldopam group, and 15% in the saline group. In patients with chronic renal insufficiency, NAC or fenoldopam offered no additional benefit over hydration with saline in preventing RCIN.