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Is There Enough Evidence to Support Use of N-Acetylcysteine in Contrast-Induced Nephropathy?
- Aine M. Kelly, MD, MS;
- Ben Dwamena, MD; and
- Ruth C. Carlos, MD, MS
- From the University of Michigan, Ann Arbor, MI 48109.
IN RESPONSE:
We thank Dr. Trivedi for detecting 2 errors in our article. First, we included 26 studies of N-acetylcysteine, not 30 as indicated in Figure 1. Second, we erroneously cited a review related to the selection of contrast media (1)—we intended to cite a 1994 study by Solomon and colleagues (2). In addition, we agree with Dr. Trivedi that substantial heterogeneity of studies evaluating N-acetylcysteine makes the conclusions of our analysis far from definitive. As stated in our article, head-to-head trials of available agents are needed to define the most effective and safe strategy of preventing contrast-induced nephropathy. Finally, the editors have published a correction about the Editors' Notes accompanying our article (3).
Dr. Gonzalez and colleagues note that previous meta-analyses have examined the efficacy of N-acetylcysteine in preventing contrast-induced nephropathy and that some of these, including their own in 2007 (4) …
