SynthesisJACC. Cardiovascular interventions2009
Sodium bicarbonate plus N-acetylcysteine prophylaxis: a meta-analysis.
Synthesis in JACC. Cardiovascular interventions, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 114 citations in OpenAlex.
- The effectiveness of N-Acetylcysteine in preventing contrast-induced nephropathy in patients undergoing contrast-enhanced computed tomography: a meta-analysis of randomized controlled trials.International urology and nephrology · 2013Pooled it
- Cardiological Society of India practice guidelines for angiography in patients with renal dysfunction.Indian heart journal · 2012Guideline
- Sodium bicarbonate supplements for treating acute kidney injury.The Cochrane database of systematic reviews · 2012Pooled it
- Effect of N-acetylcysteine pretreatment of deceased organ donors on renal allograft function: a randomized controlled trial.Transplantation · 2015Trial
- Different interventions in preventing contrast-induced nephropathy after percutaneous coronary intervention.International urology and nephrology · 2014Trial
- Repair of ruptured abdominal aortic aneurysms with bifurcated endografts: a single-center study.Clinics (Sao Paulo, Brazil) · 2014Trial
- Trial
- Activatable fluorescent ratiometric probes for early diagnosis and prognostic assessment of acute kidney injury.Science advances · 2025Article
- Nanosystems for oxidative stress regulation in the anti-inflammatory therapy of acute kidney injury.Frontiers in bioengineering and biotechnology · 2023Review
- Kidney Microcirculation as a Target for Innovative Therapies in AKI.Journal of clinical medicine · 2021Review
- Interaction of N-acetyl-l-cysteine with NaJournal of molecular liquids · 2020Article
- Management of Acute Kidney Injury Following Major Abdominal Surgery: A Contemporary Review.Journal of clinical medicine · 2020Review
- Post-contrast acute kidney injury. Part 2: risk stratification, role of hydration and other prophylactic measures, patients taking metformin and chronic dialysis patients : Recommendations for updated ESUR Contrast Medium Safety Committee guidelines.European radiology · 2018 · on this mapReview
- Comparative efficacy of pharmacological interventions for contrast-induced nephropathy prevention after coronary angiography: a network meta-analysis from randomized trials.International urology and nephrology · 2018 · on this mapReview
- Reducing Acute Kidney Injury Due to Contrast Material: How Nurses Can Improve Patient Safety.Critical care nurse · 2017Article
- Update on the renal toxicity of iodinated contrast drugs used in clinical medicine.Drug, healthcare and patient safety · 2017Review
- Acute kidney injury in the perioperative period and in intensive care units (excluding renal replacement therapies).Annals of intensive care · 2016Review
- The incidence and significance of acute kidney injury following emergent contrast administration in patients with STEMI and stroke.Internal and emergency medicine · 2016Article
- Acute Kidney Injury Risk Prediction in Patients Undergoing Coronary Angiography in a National Veterans Health Administration Cohort With External Validation.Journal of the American Heart Association · 2015Article
- A Review of the Use of Iloprost, A Synthetic Prostacyclin, in the Prevention of Radiocontrast Nephropathy in Patients Undergoing Coronary Angiography and Intervention.Clinical cardiology · 2015Review
Corrections and comments
- Comment on
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
Abstract
objectivesWe sought to conduct a meta-analysis to compare N-acetylcysteine (NAC) in combination with sodium bicarbonate (NaHCO(3)) for the prevention of contrast-induced acute kidney injury (AKI).
backgroundContrast-induced AKI is a serious consequence of cardiac catheterizations and percutaneous coronary interventions (PCI). Despite recent supporting evidence for combination therapy, not enough has been done to prevent the occurrence of contrast-induced AKI prophylactically.
methodsPublished randomized controlled trial data were collected from OVID/PubMed, Web of Science, and conference abstracts. The outcome of interest was contrast-induced AKI, defined as a >or=25% or >or=0.5 mg/dl increase in serum creatinine from baseline. Secondary outcome was renal failure requiring dialysis.
resultsTen randomized controlled trials met our criteria. Combination treatment of NAC with intravenous NaHCO(3) reduced contrast-induced AKI by 35% (relative risk: 0.65; 95% confidence interval: 0.40 to 1.05). However, the combination of N-acetylcysteine plus NaHCO(3) did not significantly reduce renal failure requiring dialysis (relative risk: 0.47; 95% confidence interval: 0.16 to 1.41).
conclusionsCombination prophylaxis with NAC and NaHCO(3) substantially reduced the occurrence of contrast-induced AKI overall but not dialysis-dependent renal failure. Combination prophylaxis should be incorporated for all high-risk patients (emergent cases or patients with chronic kidney disease) and should be strongly considered for all interventional radio-contrast procedures.
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.