Is There Enough Evidence to Support Use of <i>N</i>-Acetylcysteine in Contrast-Induced Nephropathy?
Authors: Aine M. Kelly, Ben Dwamena, Ruth C. Carlos
Journal: Annals of Internal Medicine (2008)

Letters5 August 2008Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy?Aine M. Kelly, MD, MS, Ben Dwamena, MD, and Ruth C. Carlos, MD, MSAine M. Kelly, MD, MSFrom the University of Michigan, Ann Arbor, MI 48109.Search for more papers by this author, Ben Dwamena, MDFrom the University of Michigan, Ann Arbor, MI 48109.Search for more papers by this author, and Ruth C. Carlos, MD, MSFrom the University of Michigan, Ann Arbor, MI 48109.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-149-3-200808050-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We thank Dr. Trivedi for detecting 2 errors in our article. First, we included 26 studies of N-acetylcysteine, not 30 as indicated in Figure 1. Second, we erroneously cited a review related to the selection of contrast media (1)—we intended to cite a 1994 study by Solomon and colleagues (2). In addition, we agree with Dr. Trivedi that substantial heterogeneity of studies evaluating N-acetylcysteine makes the conclusions of our analysis far from definitive. As stated in our article, head-to-head trials of available agents are needed to define the most effective and safe strategy of preventing contrast-induced nephropathy. Finally, ...References1. Solomon R, Briguori C, Bettmann M. Selection of contrast media. Kidney Int Suppl. 2006;:S39-45. [PMID: 16612400] CrossrefMedlineGoogle Scholar2. 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 Scholar3. Correction: Effectiveness of drugs for preventing contrast-induced nephropathy. Ann Intern Med. 2008;149:219. LinkGoogle Scholar4. Gonzales DA, Norsworthy KJ, Kern SJ, Banks S, Sieving PC, Star RA, et al. A meta-analysis of N-acetylcysteine in contrast-induced nephrotoxicity: unsupervised clustering to resolve heterogeneity. BMC Med. 2007;5:32. [PMID: 18001477] CrossrefMedlineGoogle Scholar5. Shyu KG, Cheng JJ, Kuan P. Acetylcysteine protects against acute renal damage in patients with abnormal renal function undergoing a coronary procedure. J Am Coll Cardiol. 2002;40:1383-8. [PMID: 12392825] CrossrefMedlineGoogle Scholar6. Diaz-Sandoval LJ, Kosowsky BD, Losordo DW. Acetylcysteine to prevent angiography-related renal tissue injury (the APART trial). Am J Cardiol. 2002;89:356-8. [PMID: 11809444] CrossrefMedlineGoogle Scholar7. Tepel M, van der Giet M, Schwarzfeld C, Laufer U, Liermann D, Zidek W. Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine. N Engl J Med. 2000;343:180-4. [PMID: 10900277] CrossrefMedlineGoogle Scholar8. MacNeill BD, Harding SA, Bazari H, Patton KK, Colon-Hernadez P, DeJoseph D, et al. Prophylaxis of contrast-induced nephropathy in patients undergoing coronary angiography. Catheter Cardiovasc Interv. 2003;60:458-61. [PMID: 14624421] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Aine M. Kelly, MD, MS; Ben Dwamena, MD; Ruth C. Carlos, MD, MSAffiliations: From the University of Michigan, Ann Arbor, MI 48109.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? Hariprasad Trivedi 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 Metrics 5 August 2008Volume 149, Issue 3Page: 215-216KeywordsClinical trial reportingClinical trialsConflicts of interestCreatinineDiabetes mellitusForecastingHypertensionInformation storage and retrievalRisk managementRisk ratio ePublished: 5 August 2008 Issue Published: 5 August 2008 Copyright & PermissionsCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...