Dilution of NAC for Contrast Induced Nephropathy

Two dilution methods:

1) 1.2g of IV N-acetylcysteine diluted in 250mls of 5% dextrose and infused intravenously over 1 hour before contrast and consider repeating one more dose after contrast.

2) IV N-acetylcysteine (150mg/kg in 500ml normal saline over 30mins immediately before contrast followed by 50mg/kg in 500ml normal saline over 4 hours. 

Recommendation:

• There is no standard regimen for IV NAC dosage for contrast induced nephropathy.
• Most  of the guidelines are depending on the NAC dosing.

References:

1. Intensive Care Unit, Prince of Wales Hospital, Chinese University of Hong Kong: Prophylaxis against contrast nephropathy 

2. Pubmed. A rapid protocol for the prevention of contrast-induced renal dysfunction: the RAPPID study.