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In studies of interventions to prevent contrast-induced nephropathy, results have been heterogeneous. Investigators performed a systematic review and meta-analysis of 41 randomized trials (that included 6379 patients) of medications to prevent nephropathy (defined as increase in serum creatinine of >0.5 mg/dL or >25% at 48 hours) after injection of iodinated contrast media. Studies addressed N-acetylcysteine, theophylline, aminophylline, fenoldopam, dopamine, iloprost, furosemide, bicarbonate, ascorbic acid, mannitol, and a statin. In most trials, enrolled patients had impaired renal function (serum creatinine >1.2 to 1.5 mg/dL), and, in all but one, the evaluated procedure was cardiac catheterization.
N-acetylcysteine, compared with saline …