Letter to the Editor: “Interactions between Serum Creatinine, Volume Status, N-Acetylcysteine, and Contrast-Induced Nephropathy”

Contrast-induced nephropathy is reported to be the third leading cause of acute renal failure. The development of contrast-induced nephropathy is associated with prolonged hospitalization, the potential need for renal replacement therapy, and increased mortality. N-acetylcysteine is commonly used for the prevention of contrast-induced nephropathy despite inconsistent results from numerous clinical trials and meta-analyses. The advantage of N-acetylcysteine in most studies was based on a decrease in the serum creatinine concentration and a decrease in oxidative stress. N-acetylcysteine itself can directly lower serum creatinine concentration without improving renal function, and hypovolemia can affect the oxidative stress. In most of the N‐acetylcysteine studies, there are a lack of volume status and secondary end points. The value of N-acetylcysteine for the prevention of contrast-induced nephropathy seems questionable. The interactions between serum creatinine, N-Acetylcysteine, volume status, and the development of contrast-induced nephropathy were discussed in this letter.