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June 4, 2003

Acetylcysteine and Renal Function Following Coronary Angiographic Procedures

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289(21):2794-2796. doi:10.1001/jama.289.21.2794-a

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.

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