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N‐acetylcysteine versus ascorbic acid or N‐acetylcysteine plus ascorbic acid in preventing contrast‐induced nephropathy: A meta‐analysis
Author(s) -
Feng Ye,
Huang Xing,
Li Lin,
Chen Zhi
Publication year - 2018
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.13068
Subject(s) - ascorbic acid , acetylcysteine , medicine , nephropathy , meta analysis , contrast induced nephropathy , antioxidant , endocrinology , biochemistry , food science , chemistry , diabetes mellitus
Aim The purpose of the present study was to evaluate the efficacy of N‐acetylcysteine (NAC) versus ascorbic acid (VC) or NAC plus (+) VC on the prevention of contrast‐induced nephropathy (CIN) in patients undergoing contrast administration. Methods We searched databases including Medline, Embase and Cochrane Library up to Feb 22 (th), 2017. Pooled risk ratios (RRs) or weighted mean difference (WMD) with their 95% confidence intervals (CIs) were calculated using fixed‐effects model or random‐effects model when appropriate. All analyses were performed using the Review Manager 5.2. Results A totalof six randomized controlled trials including 919 patients (478 cases received NAC administration and 441 cases received VC or NAC + VC administration) were considered in the meta‐analysis. Results showed that there was no significant difference in preventing CIN between NAC and NAC + VC administration as well as between NAC and VC administration. In addition, significant difference was found in serum creatinine level between NAC and VC or NAC + VC administration (WMD = −0.31, 95% CI: ‐0.48 to −0.14, P = 0.0003) as well as NAC and VC administration (WMD = −0.05, 95% CI: –0.08 to −0.02, P = 0.002). Besides, NAC and NAC + VC administration also has significant difference (WMD = −0.72, 95% CI: –1.33 to −0.11, P = 0.02). Conclusion In conclusion, the prevention effect of NAC administration and VC or NAC + VC administration on CIN was similar in patients undergoing contrast administration. But NAC administration was associated with a significantly lower serum creatinine levels compared to VC and NAC + VC administration.