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N-acetylcysteine in the Prevention of Contrast-induced Acute Kidney Injury: a Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials


Aim. To analyze the currently available published randomized controlled clinical trials to evaluate the effect of N-acetylcysteine on the incidence of contrast-induced acute kidney injury (CI-AKI).

Material and methods. The meta-analysis was performed in accordance with the PRISMA guidelines based on a search of existing literature in the PubMed/MEDLINE database for the period from 2015 to 16 February 2022. Keywords included MeSH terms «acute kidney injury» or «contrast-induced nephropathy» or «AKI» or «CIN» and «contrast media» and «N-acetylcysteine». The RoB 2 tool was used to assess study bias.

Results: When searching based on the initially selected statistics, 98 publications were identified, some of them were excluded from the analysis due to non-compliance with the inclusion criteria in this meta-analysis, 7 studies of unused sources of detection were ultimately selected, the total number of patients in the discovery was 10394.The results of the meta-analysis revealed that in patients treated with N-acetylcysteine CI-AKI developed with the same frequency as in patients who did not observe such therapy as a prophylaxis for this disease (odds ratio 1.06, 95% confidence interval 0.911.23, p=0.46).

Conclusion. The use of N-acytelcysteine does not offer any advantage in reducing the incidence of CI-AKI compared with the administration of saline solutions (sodium bicarbonate or sodium chloride 0.9%) or placebo.

About the Authors

E. M. Mezhonov
Regional clinical hospital №1; Tyumen State Medical University
Russian Federation

Evgeny M. Mezhonov.


eLibrary SPIN 2935-9617

Yu. A. Vyalkina
Tyumen State Medical University
Russian Federation

Yulia A. Vyalkina.


eLibrary SPIN 4237-5048

S. V. Shalaev
Regional clinical hospital №1; Tyumen State Medical University
Russian Federation

Sergey V. Shalaev.


eLibrary SPIN 5285-0082


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For citations:

Mezhonov E.M., Vyalkina Yu.A., Shalaev S.V. N-acetylcysteine in the Prevention of Contrast-induced Acute Kidney Injury: a Systematic Review and Meta-analysis of Randomized Controlled Clinical Trials. Rational Pharmacotherapy in Cardiology. 2022;18(4):455-461. (In Russ.)

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