Pharmacological Strategies to Prevent Contrast-Induced Acute Kidney Injury

Table 5

Prospective, randomized clinical trials comparing efficacy of vitamin C with placebo and other agents for contrast-induced AKI after angiography prophylaxis.

Authors	Year	Type of procedure and contrast media	Number of patients; Intervention versus control	Study protocol		Intravascular volume expansion and NAC protocol	CI-AKI definition	Mean GFR; Intervention versus control (mL/min/1.73 m^2)	Incidence of CI-AKI		RRT requirement; Intervention versus control (%)
				Intervention	Control				Intervention versus control (%)	𝑃 value
Spargias et al. [88]	2004	CAG; LONICM or; IONICM	118 versus 113	Ascorbic acid 3 g po 2 hours before and 2 g in the night and in the morning after	Placebo	NSS 50–125 mL/h from randomization to 6 hours after	↑Cr ≥25%/2 days or; ↑Cr ≥0.5/2 days	61.1 versus 68.1	9 versus 20	0.02	ND
Boscheri et al. [89]	2007	CAG; ND	74 versus 69	Ascorbic acid 1 g	Placebo	NSS before and after	ND	ND	6.8 versus 4.3	NS	ND
Jo et al. [90]	2009	CAG; Iodixanol	106 versus 106	Ascorbic acid po q12h 3 and 2 g before and 2 and 2 g after	NAC 1200 mg po bid 4 doses, begin 1st dose in the evening before	N/2 1 mL/kg/h 12 hours before and after	↑Cr ≥25%/2 days or; ↑Cr ≥0.5/2 days	53.7 versus 53.7	4.4 versus 1.2	0.370	2 versus 1
Zhou and chen [91]	2012	CAG; Unspecified	74 versus 82	Ascorbic acid 3 g IV before and 0.5 g po q12h for 2 days after	Placebo	NSS 1 mL/kg/h 4 hours before and 12 hours after	↑Cr ≥25%/2 days or; ↑Cr ≥0.5/2 days	52.5 versus 53.2	6.3 versus 5.4	0.69	ND
Brueck et al. [92]	2013	CAG; Iopromide	104 versus 208 versus 208	Ascorbic acid 500 mg IV at 24 hours and 1 hour before	(1) NAC 600 mg iv at 24 hours and 1 hour before; (2) Placebo	NSS 1 mL/kg/h 12 hours before and 12 hours after	↑Cr ≥0.5/3 days	43.0 versus 40.2 versus 42.0	24.5 versus 27.6 versus 32.1	0.11*; 0.20**	0 versus 0 versus 0

𝑃 value of *ascorbic acid and **NAC compared to placebo group.
bid: twice daily; CAG: coronary angiography; CI-AKI: contrast-induced acute kidney injury; Cr: creatinine; g: gram; h: hour; IONICM: isoosmolarity nonionic contrast media; IV: intravenous; kg: kilogram body weight; LONICM: low osmolarity nonionic contrast media; kg: kilogram body weight; mg: milligram; mL: milliliter; NAC: N-acetylcysteine; ND: no data; NSS: normal saline solution; N/2: 0.45% NaCl; po: per oral route; q12h: every 12 hours; RRT: renal replacement therapy.