Radiology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

DOI: 10.1148/radiol.2393041456
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Huber, W.
Right arrow Articles by Schmid, R. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Huber, W.
Right arrow Articles by Schmid, R. M.
(Radiology 2006;239:793-804.)
© RSNA, 2006

Genitourinary Imaging

Prophylaxis of Contrast Material–induced Nephropathy in Patients in Intensive Care: Acetylcysteine, Theophylline, or Both? A Randomized Study1

Wolfgang Huber, MD, Florian Eckel, MD, Michael Hennig, PhD, Hilkea Rosenbrock, PhD, Annette Wacker, MD, Dieter Saur, MD, Angelika Sennefelder, MD, Romain Hennico, MD, Cordula Schenk, MD, Alexander Meining, MD, Renate Schmelz, MD, Ralph Fritsch, MD, Wolfgang Weiss, MD, Peter Hamar, MD, Uwe Heemann, MD and Roland M. Schmid, MD

1 From the II. Medizinische Klinik (W.H., F.E., D.S., A.S., R.H., C.S., A.M., R.S., R.F., U.H., R.M.S.); Institut für Medizinische Statistik und Epidemiologie (M.H.), Institut für Klinische Chemie (H.R.), Universitaetsklinik Tuebingen, Kinderkardiologie (A.W.), and Department of Radiology (W.W.), Klinikum Rechts der Isar, Technische Universität München, Intensivstation 2/11, Ismaningerstr 22, D-81675 Munich, Germany; and Institut für Pathophysiologie; Semmelweiss Universität, Budapest, Hungary (P.H.) Received August 24, 2004; revision requested October 11; revision received May 20, 2005; accepted June 21; final version accepted September 6. Address correspondence to W.H. (e-mail: Wolfgg.Huber{at}t-online.de).

Purpose: To prospectively compare the protective effect of acetylcysteine, theophylline, and both agents combined in patients who are admitted to the intensive care unit with at least one risk factor for contrast material–induced nephropathy and who receive at least 100 mL of iodinated contrast medium.

Materials and Methods: Institutional ethics review board approval and informed consent were obtained. A total of 91 patients (mean age, 58.5 years ± 14.8 [standard deviation]; 31 women, 60 men; 150 examinations) were admitted to the intensive care unit with at least one risk factor for contrast-induced nephropathy and received either (a) 200 mg theophylline 30 minutes before contrast medium administration (group T), (b) 600 mg acetylcysteine twice daily on the day of and (if possible) the day before the examination (group A), or (c) both agents combined (group AT). The primary endpoint for this study was the incidence of contrast-induced nephropathy ({chi}2 test).

Results: Groups T, A, and AT were comparable with regard to baseline creatinine levels and the amount of contrast medium administered. The incidence of contrast-induced nephropathy in groups T, A, and AT was 2%, 12%, and 4%, respectively, and was significantly lower in group T than in group A (P = .047). There was no significant difference in the incidence of contrast-induced nephropathy between groups A and AT (P = .148) or between groups T and AT (P = .53). For group A, serum creatinine did not change after 12, 24, or 48 hours compared with baseline. Creatinine levels in group T decreased 12 hours (1.19 mg/dL ± 0.58; P = .008) and 48 hours (1.16 mg/dL ± 0.55; P = .034) after contrast material injection compared with baseline (1.25 mg/dL ± 0.61). In group AT, creatinine significantly decreased 24 hours (1.21 mg/dL ± 0.74; P = .003) and 48 hours (1.17 mg/dL ± 0.69; P < .001) after contrast material injection compared with baseline (1.28 mg/dL ± 0.74). Group A had significantly higher maximal increases in creatinine than groups T and AT (P = .014).

Conclusion: For prophylaxis of contrast-induced nephropathy in patients who are admitted to the intensive care unit and who receive 100 mL or more of contrast medium, theophylline is superior to acetylcysteine.

© RSNA, 2006




This article has been cited by other articles:


Home page
 Am. J. Roentgenol.Home page
J. H. Newhouse, D. Kho, Q. A. Rao, and J. Starren
Frequency of Serum Creatinine Changes in the Absence of Iodinated Contrast Material: Implications for Studies of Contrast Nephrotoxicity
Am. J. Roentgenol., August 1, 2008; 191(2): 376 - 382.
[Abstract] [Full Text] [PDF]

Home page
 RadiologyHome page
M. J. Schultz, W. Huber, A. Umgelter, M. Franzen, and W. Reindl
N-acetylcysteine and/or Theophylline as a Preventive Measure for Contrast Agent induced Nephropathy: We Should Use Better Markers for Detection of Renal Function
Radiology, December 1, 2007; 245(3): 918 - 919.
[Full Text] [PDF]