Walker Paul D, Brokering Kristi L, Theobald John C
Auburn University, Harrison School of Pharmacy, Auburn, Alabama, USA.
Pharmacotherapy. 2003 Dec;23(12):1617-26. doi: 10.1592/phco.23.15.1617.31958.
Radiographic contrast material-induced nephropathy (RCIN) is the third most common cause of hospital-acquired renal insufficiency and has been associated with an increase in patient mortality. Many strategies to prevent RCIN have been explored unsuccessfully. The standard of care remains hydration with 0.45% sodium chloride before and after administration of contrast material. Recently, N-acetylcysteine and fenoldopam have been studied to determine their efficacy in preventing RCIN. Of seven prospective studies using various dosing regimens of N-acetylcysteine, four revealed beneficial results. Although some discrepancies exist, the data strongly suggest that N-acetylcysteine has a role in patients at risk for the development of RCIN. The data for fenoldopam are more limited, with only one retrospective study showing benefit. Additional prospective data are required to determine if fenoldopam has a role in the prevention of RCIN.
放射造影剂所致肾病（RCIN）是医院获得性肾功能不全的第三大常见病因，且与患者死亡率增加相关。人们探索了许多预防RCIN的策略，但均未成功。目前的标准治疗方法仍是在使用造影剂前后用0.45%的氯化钠进行水化。最近，对N-乙酰半胱氨酸和非诺多泮进行了研究，以确定它们在预防RCIN方面的疗效。在七项使用不同给药方案的N-乙酰半胱氨酸的前瞻性研究中，有四项显示出有益结果。尽管存在一些差异，但数据强烈表明N-乙酰半胱氨酸对有发生RCIN风险的患者有作用。非诺多泮的数据更为有限，仅有一项回顾性研究显示其有益处。需要更多的前瞻性数据来确定非诺多泮在预防RCIN方面是否有作用。
