N-acetylcysteine helps protect kidneys from contrast agents used during imaging scans
The results of a meta-analysis published in the February 19, 2008 issue of the Annals of InternalMedicine found that N-acetylcysteine works better than other agents to help prevent kidneydamage (nephropathy) caused by iodine-containing dyes known as contrast agents which are usedto enhance the visualization of organs or other structures during CT scans, angiograms and otherimaging scans. Contrast-induced nephropathy is diagnosed when blood creatinine, an indicator ofkidney function, increases 25 percent or more within 48 hours following contrast agentadministration.
For the review, Aine Kelly, MD, MS, and her University of Michigan colleagues selected 41randomized, controlled trials that compared the protective ability of a control agent such as salineto N-acetylcysteine, theophylline, fenoldopam, dopamine, iloprost, statin, furosemide, ormannitol in a group of patients in which intravenous iodinated contrast agents were used. Theanalysis did not include studies involving non-iodinated contrast agents such as barium orgadolinium.
Of the agents analyzed, only N-acetylcysteine was clearly shown to help prevent contrast-inducednephropathy. Although theophylline was found to reduce nephropathy risk more than saline, theamount was not enough to be considered significant. One drug, furosemide, actually increasedkidney damage risk.
Elderly individuals and those with diabetes or heart failure have the greatest risk of experiencingcontrast-induced nephropathy, and could benefit the most from prophylactic N-acetylcysteineuse. Mild to moderate kidney damage occurs following CT scans in one in four of these high-riskindividuals. Even among those with normal kidney function, an estimated one in ten experiencessome kidney damage from the use of these contrast agents. Dr Kelly recommended that men andwomen with impaired kidney function speak up when their physician orders a CT scan orangiogram to ensure that they are given an N-acetylcysteine tablet beforehand. Healthyindividuals may wish to request that their blood creatinine levels be tested prior to undergoingthese scans, in order to ascertain whether they have any unknown kidney impairment.
"Millions of people receive contrast agent each year, including most heart patients who haveangioplasties and stents, as well as those having a CT scan. Contrast agent helps physicians seethe things we need to see, but it also does pose a hazard to some people," Dr Kelly stated. "Thisdrug, which is quick, convenient, inexpensive and widely available, with no major side effects,appears to be the best choice to protect those whose kidneys are most at risk."
Reprinted, with permission, from Life Extension Foundation. Willner Chemists carries LifeExtension nutritional supplements, including their N-Acetylcysteine Caps, 600 mg.
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N-acetyl cysteine is the more efficiently absorbed and used form of the amino acid, L-cysteine.L-cysteine plays a role in the sulfation cycle, acting as a sulfur donor in phase II detoxificationand as a methyl donor in the conversion of homocysteine to methionine. N-acetyl cysteine hasantioxidant properties, and helps to maintain healthy levels of the liver's natural detoxifier,glutathione. In addition, N-acetyl cysteine has been used to break up pulmonary and bronchialmucus.