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Recently, the use of oral acetylcysteine has become widespread as a renal protective measure for patients exposed to intravenous radiocontrast dye. We sought to determine the effects of oral acetylcysteine on renal function among 30 consecutive elderly (mean age 77.8 years) high risk patients who had undergone elective renal or cardiac arteriographic studies. All patients had baseline renal impairment (mean serum creatinine 2.7 mg/dl, Cockcroft-Gault creatinine clearance 25.0 ml/min ). All patients received an intravenous infusion (IVF) of 5% dextrose with 0.45% saline solution begun 8 hours before and continued for 24 hours after the contrast exposure. Twelve patients received oral acetylcysteine (AC) 600 mg at 12 hour intervals for 4 doses starting the evening before the arteriographic study. Eighteen patients received intravenous fluid only. There were were no differences between the groups in age, baseline renal function and volume of contrast administered. Baseline systolic blood pressure was slightly higher in the IVF-only group than in the AC-treated group (153 20 vs. 135 18 mmHg, p 0.05). There were 3 patients with diabetes mellitus in each group.

The effect of acetylcysteine on renal function in elderly high-risk patients exposed to arteriographic contrast dye