Prevention

Give high-risk patients pre- and post-contrast 

• 0.45% saline (1 mg/kg/hr for 12 hours) ^c
• acetylcysteine 600 mg orally twice daily ^a

Why?

• Patients with chronic renal insufficiency who received acetylcysteine and saline compared with placebo and saline are less likely to develop an acute reduction in renal function, and have a smaller change in serum creatinine levels (on average 50 µmol less). ^a

Acetylcysteine reduces worsening renal function following contrast media.

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
chronic renal insufficiency undergoing CT contrast study a	acetylcysteine and saline infusion	placebo and saline infusion	acute reduction in renal function at 2 days	21%	89% (14% to 98%)	5 (3 to 18)