Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Kay and colleagues1 found that patients who received acetylcysteine
had lower serum creatinine levels and higher creatinine clearance 2 days after
coronary angiographic procedures than those who did not. However, the mean
creatinine levels in the acetylcysteine group continued to increase, and the
creatinine clearance continued to decrease, from day 2 to day 7, such that
by day 7 the difference between groups was no longer significant for creatinine
and marginally significant for creatinine clearance. Since creatinine levels
may not peak until a few days following radiocontrast exposure, it is unclear
whether acetylcysteine administration merely delayed, rather than prevented,
the development of nephropathy.
Shen AY. Acetylcysteine and Renal Function Following Coronary Angiographic Procedures. JAMA. 2003;289(21):2794-2796. doi:10.1001/jama.289.21.2794-a