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Many studies have evaluated approaches to prevention of contrast-induced nephropathy (CIN), including oral or intravenous hydration, bicarbonate infusion, and administration of acetylcysteine, an antioxidant and glutathione substitute. These investigators compared IV acetylcysteine plus normal saline to normal saline alone in a randomized trial of emergency department patients undergoing chest or abdominal computed tomography with IV contrast who had at least one risk factor for CIN.
CIN was defined as an increase in creatinine of 25% or 0.5 mg/dL within 48 to 72 hours after contrast administration. The study was stopped early for futility because the incidence of CIN did not differ between groups and the safety monitoring board did not thin…