Korean Journal of Nephrology 2007;26(6):699-704.
The Protective Effect of Recombinant Human Erythropoietin and N-acetylcysteine in Radiocontrast-Induced Nephrotoxicity
Sarah Chung, M.D., Eui Sik Kim, M.D., Ji Yoon Jung, M.D. Nan Hee Kim, M.D., Dae Eun Choi, M.D., Ki-Ryang Na, M.D. Kang Wook Lee, M.D. and Young-Tai Shin, M.D.
Division of Nephrology, Department of Internal Medicine, College of Medicine Chungnam National University, Daejeon, Korea
원저 : Recombinant Human Erythropoietin 및 N-acetylcysteine의 방사선 조영제에 의한 신독성 예방효과
정사라 김의식 정지윤 김난희 최대은 나기량 이강욱 신영태
충남대학교 의과대학 내과학교실
Abstract
Purpose : We investigated the effects of recombinant human erythropoietin (EPO) and N-acetylcysteine (NAC) in the prevention of radiocontrast-induced nephrotoxicity in patients with underlying renal dysfunction, who are regarded as a high risk group. Methods : This study included 77 individuals with renal insufficiency, defined by a serum creatinine concentration above 1.2 mg/dL or creatinine clearance of more than 15 mL/min/1.73m2 and less than 60 mL/min/1.73m2. These patients who needed radiologic interventions including the use of radiocontrast materials from August 2006 to May 2007 were randomly assigned to one of four groups, which were treated with EPO only, NAC only, EPO plus NAC and placebo respectively. The serum creatinine and cystatin-C were measured before, 24 hours and 48 hours after the intervention. The creatinine clearance was obtained using the Cockcroft-Gault equation. Results : The serum level of creatinine in EPO plus NAC group was not significantly elevated 24 and 48 hours after radiocontrast exposure compared to control group (p=0.012). Also, the creatinine clearance of EPO plus NAC group was not significantly decreased after radiocontrast exposure compared to control group (p=0.046). The serum level of creatinine in EPO and NAC group increased less than control group, but there were no significant differences between the groups. Also, the creatinine clearance in EPO and NAC group decreased less than control group, but there were no significant differences between the groups. Conclusion : EPO plus NAC showed a renoprotective effect on radiocontrast study in patients with underlying renal dysfunction.
Key Words: Contrast media, Erythropoietin, Acetylcysteine


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