N-acethyl cysteine(A.C.C) has crucial antioxidant role in contrast nephropathy. It is also known as antidote of acetaminophen in toxic states.I want to investigate the mechanism of action and standard dose of adminstration of it.
N-acetylcysteine acts as an antioxidant to inhibit ischemic cell death in the kidney. It is a potent scavenger of ROS, protect tubule cells from apoptosis related to reactive oxygen species, reduced kidney damage and improves endothelium-dependent vasodilation.
You can benefit from the following links.
1. Hung Y-M, Lin S-L, Hung S-Y, Huang W-C, Wang PY-P. Preventing radiocontrast-induced nephropathy in chronic kidney disease patients undergoing coronary angiography. World Journal of Cardiology. 2012;4(5):157-172. doi:10.4330/wjc.v4.i5.157.
2. Sun Z, Fu Q, Cao L, Jin W, Cheng L, Li Z. Intravenous N-Acetylcysteine for Prevention of Contrast-Induced Nephropathy: A Meta-Analysis of Randomized, Controlled Trials. Lipinski M, ed. PLoS ONE. 2013;8(1):e55124. doi:10.1371/journal. pone.0055124.
3. Jo S-H. N-acetylcysteine for Prevention of Contrast-Induced Nephropathy: A Narrative Review. Korean Circulation Journal. 2011;41(12):695-702. doi:10.4070/kcj.2011.41.12.695.
4. Michele Andreucci, Teresa Faga, Antonio Pisani, Massimo Sabbatini, Domenico Russo, and Ashour Michael, “Prevention of Contrast-Induced Nephropathy through a Knowledge of Its Pathogenesis and Risk Factors,” The Scientific World Journal, vol. 2014, Article ID 823169, 16 pages, 2014. doi:10.1155/2014/ 823169.
Dear Entedhar, thanks a lot for your complete answer and suggested articles.
You can read this article: Prevention of contrast nephropathy associated with angiography
https://www.uptodate.com/contents/prevention-of-contrast-nephropathy-associated-with-angiography
With the lower dose and iso-osmolar types of contrast, CIN is less frequent - sometimes debated to be a myth.
Apart from hydration, I do not think pharmacological prophylaxis of benefit.
In a critically-ill patient, the benefit of diagnosing or excluding abdominal pathology clearly out-weight any risk of contrast.
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