URG-L: acetyl cysteine et injection de produit de contraste

[taboulet]

Les injections de produit de contraste sont d�l�t�res sur rein malade.
Mais voil� une publication (du NEJM 2000) qui devrait nous faciliter la
vie. Une simple administration per os (600 mg orally twice daily)
pr�viendrait la n�phrotoxicit� r�nale des  produits de contraste
utilis�s par les radiologues. Je n'arrive pas � comprendre pourquoi les
radiologues et les n�phrologues ne sont pas venus nous en parler plus
t�t. Des info l� dessus ? Moi j'ai commenc� mais je manque de recul. PT

Title: Entrez-PubMed

PubMed Nucleotide Protein Genome Structure PopSet Taxonomy OMIM Books  Search PubMed Protein Nucleotide Structure Genome PopSet OMIM Taxonomy Books ProbeSet 3D Domains UniSTS for   Limits Preview/Index History Clipboard Details     About Entrez Entrez PubMed Overview Help | FAQ Tutorial New/Noteworthy PubMed Services Journal Browser MeSH Browser Single Citation Matcher Batch Citation Matcher Clinical Queries LinkOut Cubby Related Resources Order Documents NLM Gateway TOXNET Consumer Health Clinical Alerts ClinicalTrials.gov PubMed Central Privacy Policy Summary Brief Abstract Citation ASN.1 MEDLINE XML LinkOut Related Articles Genome Links ProbeSet Links Nucleotide Links OMIM Links PopSet Links Protein Links Structure Links Sort Author Journal Pub Date 1: N Engl J Med 2000 Jul 20;343(3):180-4 Related Articles, Books, LinkOut Comment in: N Engl J Med. 2000 Jul 20;343(3):210-2. Prevention of radiographic-contrast-agent-induced reductions in renal function by acetylcysteine. Tepel M, van der Giet M, Schwarzfeld C, Laufer U, Liermann D, Zidek W. Medizinische Klinik I, Universitatsklinik Marienhospital, Ruhr-Universitat Bochum, Herne, Germany. [EMAIL PROTECTED] BACKGROUND: Radiographic contrast agents can cause a reduction in renal function that may be due to reactive oxygen species. Whether the reduction can be prevented by the administration of antioxidants is unknown. METHODS: We prospectively studied 83 patients with chronic renal insufficiency (mean [+/-SD] serum creatinine concentration, 2.4+/-1.3 mg per deciliter [216+/-116 micromol per liter]) who were undergoing computed tomography with a nonionic, low-osmolality contrast agent. Patients were randomly assigned either to receive the antioxidant acetylcysteine (600 mg orally twice daily) and 0.45 percent saline intravenously, before and after administration of the contrast agent, or to receive placebo and saline. RESULTS: Ten of the 83 patients (12 percent) had an increase of at least 0.5 mg per deciliter (44 micromol per liter) in the serum creatinine concentration 48 hours after administration of the contrast agent: 1 of the 41 patients in the acetylcysteine group (2 percent) and 9 of the 42 patients in the control group (21 percent; P=0.01; relative risk, 0.1; 95 percent confidence interval, 0.02 to 0.9). In the acetylcysteine group, the mean serum creatinine concentration decreased significantly (P<0.001), from 2.5+/-1.3 to 2.1+/-1.3 mg per deciliter (220+/-118 to 186+/-112 micromol per liter) 48 hours after the administration of the contrast medium, whereas in the control group, the mean serum creatinine concentration increased nonsignificantly (P=0.18), from 2.4+/-1.3 to 2.6+/-1.5 mg per deciliter (212+/-114 to 226+/-133 micromol per liter) (P<0.001 for the comparison between groups). CONCLUSIONS: Prophylactic oral administration of the antioxidant acetylcysteine, along with hydration, prevents the reduction in renal function induced by contrast agents in patients with chronic renal insufficiency. Publication Types: Clinical Trial Randomized Controlled Trial PMID: 10900277 [PubMed - indexed for MEDLINE] Summary Brief Abstract Citation ASN.1 MEDLINE XML LinkOut Related Articles Genome Links ProbeSet Links Nucleotide Links OMIM Links PopSet Links Protein Links Structure Links Sort Author Journal Pub Date              Write to the Help Desk NCBI | NLM | NIH Department of Health & Human Services Freedom of Information Act | Disclaimer i686-pc-linux-gnu Feb 4 2002 11:36:43