Effectiveness of acetylcysteine on preventing renal dysfunction in patients undergoing coronary procedures.

OBJECTIVE Experimental studies have shown that acetylcysteine is beneficial in preserving kidney function during coronary procedures. However, its role in routine clinical practice is not known. METHODS We studied 75 consecutive patients undergoing coronary procedures who received acetylcysteine, and compared them with 56 consecutive similar patients who served as control. All patients had renal dysfunction, and a single operator did all procedures. RESULTS Patients in the acetylcysteine group had a decrease in serum creatinine of 0.1 +/- 0.3 mg/dl versus a rise of 0.2 +/- 0.6 mg/dl in the control group (P<0.001). When the benefit in the active drug group was correlated with baseline creatinine, it occurred in all patients, regardless of the degree of kidney dysfunction. CONCLUSION We conclude that in patients with varying degrees of renal dysfunction who undergo coronary procedures, acetylcysteine should be used in addition to hydration. It should be an accepted clinical practice that should be adopted routinely in the cardiac catheterization laboratory.