Is There Enough Evidence to Support Use of <i>N</i>-Acetylcysteine in Contrast-Induced Nephropathy?
Authors: Hariprasad Trivedi
Journal: Annals of Internal Medicine (2008)

Letters5 August 2008Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy?Hariprasad Trivedi, MDHariprasad Trivedi, MDFrom Medical College of Wisconsin, Milwaukee, WI 53226.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-3-200808050-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I would like to applaud Kelly and colleagues for their exhaustive meta-analysis (1), and I have some comments about their analysis.First, exactly how many studies involving N-acetylcysteine were included in the meta-analysis? The number of N-acetylcysteine studies in Figure 1 differs from the numbers listed in the Table and Figure 2. Why were 4 studies excluded after they were deemed to have satisfied inclusion criteria? Second, the paper cited as a study involving furosemide and mannitol (Table) is a review relating to selection of contrast media (2). The actual mannitol and furosemide study was published elsewhere ...References1. Kelly AM, Dwamena B, Cronin P, Bernstein SJ, Carlos RC. Meta-analysis: effectiveness of drugs for preventing contrast-induced nephropathy. Ann Intern Med. 2008;148:284-94. [PMID: 18283206] LinkGoogle Scholar2. Solomon R, Briguori C, Biguori C, Bettmann M. Selection of contrast media. Kidney Int Suppl. 2006;:S39-45. [PMID: 16612400] CrossrefMedlineGoogle Scholar3. Solomon R, Werner C, Mann D, D'Elia J, Silva P. Effects of saline, mannitol, and furosemide to prevent acute decreases in renal function induced by radiocontrast agents. N Engl J Med. 1994;331:1416-20. [PMID: 7969280] CrossrefMedlineGoogle Scholar4. Hulley SB, Cummings SR, Browner WS, Grady D, Hearst N, Newman TB. Designing Clinical Research. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2001. Google Scholar5. Deeks JJ, Higgins, JPT, Altman DG. Analysing and presenting results. In: Higgins JP, Green S, eds. Cochrane Handbook for Systematic Reviews of Interventions 4.2.5. Updated May 2005. Section 8. Accessed at www.cochrane.dk/cochrane/handbook/hbook.htm on 19 March 2008. Google Scholar6. Abizaid AS, Clark CE, Mintz GS, Dosa S, Popma JJ, Pichard AD, et al. Effects of dopamine and aminophylline on contrast-induced acute renal failure after coronary angioplasty in patients with preexisting renal insufficiency. Am J Cardiol. 1999;83:260-3, A5. [PMID: 10073832] CrossrefMedlineGoogle Scholar7. Huber W, Ilgmann K, Page M, Hennig M, Schweigart U, Jeschke B, et al. Effect of theophylline on contrast material-nephropathy in patients with chronic renal insufficiency: controlled, randomized, double-blinded study. Radiology. 2002;223:772-9. [PMID: 12034949] CrossrefMedlineGoogle Scholar8. Huber W, Schipek C, Ilgmann K, Page M, Hennig M, Wacker A, et al. Effectiveness of theophylline prophylaxis of renal impairment after coronary angiography in patients with chronic renal insufficiency. Am J Cardiol. 2003;91:1157-62. [PMID: 12745095] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Medical College of Wisconsin, Milwaukee, WI 53226.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-analysis: Effectiveness of Drugs for Preventing Contrast-Induced Nephropathy Aine M. Kelly , Ben Dwamena , Paul Cronin , Steven J. Bernstein , and Ruth C. Carlos Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy? Denise A. Gonzales , Robert A. Star , Steven J. Kern , Charles Natanson , and Robert L. Danner Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy? Giuseppe Ferrante , Didier Locca , and Peter Barlis Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy? Otavio Berwanger Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy? Aine M. Kelly , Ben Dwamena , and Ruth C. Carlos Metrics Cited byContrast-induced Acute Kidney InjuryGuidelines on the use of iodinated contrast media in patients with kidney disease 2012: digest versionGuidelines on the use of iodinated contrast media in patients with kidney disease 2012: digest version 5 August 2008Volume 149, Issue 3Page: 213KeywordsAngiographyConflicts of interestCreatinineMannitolResearch laboratories ePublished: 5 August 2008 Issue Published: 5 August 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...