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Study: Before a CT scan or angiogram, many people should take inexpensive drug to protect kidneys
Date:2/18/2008

octor orders a CT scan, angiogram or angioplasty, and make sure they get a tablet of N-acetylcysteine beforehand.

And, since most kidney problems cause no symptoms, even healthy people might want to ask their doctors to test their blood creatinine levels before sending them for a scan.

Creatinine levels go up when the kidneys arent operating efficiently. Contrast-induced nephropathy is defined as a 25 percent or greater increase in creatinine within 48 hours of receiving contrast agent. The new study evaluated the impact of pre-scan medicines by looking at their impact on patients creatinine levels, as a surrogate for kidney function.

The problem of contrast-induced nephropathy is a relatively recent one a byproduct of the dramatic increase in the use of CT scans and X-ray guided procedures such as angioplasty.

The benefit of these scans is not in question: Intense X-rays can reveal valuable information about injuries, diseases, and patients response to treatment. Iodine-containing agents allow doctors to improve the scans even further, giving better contrast between the blood vessels and tissue, because X-rays are scattered differently by iodine. But as the iodine is carried by the blood to the kidneys, and filtered out into the urine, the iodine can upset the delicate balance that keeps the kidneys functioning.

In recent years, manufacturers of contrast agents have begun to offer different formulations that may pose less risk to patients kidneys. More expensive low-iodine and iodine-free agents are available to especially vulnerable patients, and to people who are allergic to iodine. But for everyone else, medical imaging specialists have tried to find ways to prevent the damage.

N-acetylcysteine is already widely used to clear mucus in cystic fibrosis patients, and to treat overdoses of acetaminophen. Its also being studied for other uses.

Tablets of prescription-strength N-acetylcysteine are i
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
Source:Eurekalert

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