WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

( An ISO 9001:2015 Certified International Journal )

An International Peer Review Journal for Medical Science and Pharma Professionals
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Indexing

Abstract

THE ADMINISTRATION OF N-ACETYLCYSTEINE AS PREVENTION OF NEPHROPATHY IN HIGH RISK PATIENTS UNDERGOING CORONARY ANGIOGRAPHY IN TERTIARY CARE HOSPITAL, KARACHI, PAKISTAN

Dr. Syed Meerab Javed, Dr. Afifa Saulat and *Dr. Anwar Nabeel Jafri

ABSTRACT

Introduction: Contrast induced nephropathy is reported to be the third most common cause of in hospital acute kidney injury. There are enormous impacts of the development of this complication in terms of hospital stay, morbidity, mortality and long term dialysis dependence. Since there are no appropriate treatments to this complication much of the focus has been on prevention. N-acetylcysteine is one of the most common drugs used in this perspective; however, there are a number of studies with conflicting results regarding the efficacy of this compound. Hence the need to evaluate the significance of this compound in prevention of contrast induced nephropathy in our population. Objective:To determine the frequency of contrast induced nephropathy in patients undergoing coronary angiography and intervention receiving N-acetylcystein as a prophylaxis at Aga Khan University Hospital. Study design: Cross sectional study. Settings: Department of Medicine, Aga Khan University Hospital. Materisls and Methods: Patients admitted in coronary care unit, Aga Khan university Hospital, receiving N-acetylcysteine as a prophylaxis for contrast induced nephropathy before coronary angiography and intervention were included in this study provided they meet the inclusion criteria. Serum creatinine were noted at the baseline and then at 48 hours post contrast exposure. An increase of 0.5 mg/dl above the baseline creatinine was labeled as contrast induced nephropathy. Comorbid conditions including diabetes and chronic kidney disease were noted, so were the age of the patient. Results: The frequency of contrast induced nephropathy in patients receiving N-acetylcysteine as a prophylaxis for coronary angiography and intervention was found to be 19.6%. The frequency was observed to increase with increase in age of the patients, mean serum creatinine of all patients on presentation was 1.557 (+/- 0.5539) mg/dl. All of these patients received N-acetylcysteine as a prophylaxis for contrast induced nephropathy and the mean serum creatinine 48 hours post exposure to contrast was found to be 1.632 (1.2001) mg/dl. Conclusion: Prophylactic administration of N-acetylcysteine for the prevention of contrast induced nephropathy fail to show a benefit in terms of prevention of contrast induced nephropathy, since, the frequency observed in this study was significantly higher to the incidence of contrast induced nephropathy reported in the earlier studies.

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