Contrast Nephropathy: Prevention

• No benefit of Diuretics, Mannitol, Fendolopam, ANP, Calcium Channel Blockers, Endothelin Antagonists:

• N-acetylcysteine: 600-1200 mg BID X 2 days

• 1/2 NS or NS

• Sodium Bicarbonate

• REMEDIAL: Double Blind RCT compared Bicarb vs NS in High Risk Patients (creatinine > 2 mg/dl)

• All received NAC

• Results: % CN ATN

• NS (11/111) 9.9

• Bicarb (2/108) 1.9

• Circulation (2007) 115: 1211-7