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Radiocontrast agents given to patients undergoing coronary intervention and other imaging procedures can lead to acute renal failure, particularly among patients with underlying renal insufficiency. Multiple strategies have been proposed to avoid exacerbation of renal dysfunction in patients who must be exposed to contrast agents. In a prospective randomized study, researchers evaluated the effects of three regimens for prophylaxis against contrast-induced nephrotoxicity — saline plus N-acetylcysteine (NAC), saline plus ascorbic acid plus NAC, and sodium bicarbonate plus NAC — in 326 consecutive patients with chronic kidney disease (creatinine ≥2 mg/dL) who required contrast agents for various procedures.
The amount of contrast administered …