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IV N-Acetylcysteine and Emergency CT: Use of Serum Creatinine and Cystatin C as Markers of Radiocontrast Nephrotoxicity

Pierre-Alexandre Poletti1, Patrick Saudan2, Alexandra Platon1, Bernadette Mermillod1, Anna-Maria Sautter3, Bernard Vermeulen4, François P. Sarasin4, Christoph D. Becker1 and Pierre-Yves Martin2

1 Department of Radiology, University Hospital of Geneva, 24, rue Micheli-du-Crest, 1211 Genève 14, Switzerland.
2 Service of Nephrology, University Hospital of Geneva, Geneva, Switzerland.
3 Service of Clinical Pharmacology and Pharmacy, University Hospital of Geneva, Geneva, Switzerland.
4 Emergency Center, University Hospital of Geneva, Geneva, Switzerland.


Figure 1
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  		Fig. 1A —Time evolution of markers of glomerular filtration rate in each patient. Thick horizontal lines indicate mean concentrations, vertical lines indicate 95% CI, and dotted lines indicate patients with missing data. Graphs show creatinine concentration after CT in N-acetylcysteine (A) and control (B) groups.

 

Figure 2
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  		Fig. 1B —Time evolution of markers of glomerular filtration rate in each patient. Thick horizontal lines indicate mean concentrations, vertical lines indicate 95% CI, and dotted lines indicate patients with missing data. Graphs show creatinine concentration after CT in N-acetylcysteine (A) and control (B) groups.

 

Figure 3
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  		Fig. 1C —Time evolution of markers of glomerular filtration rate in each patient. Thick horizontal lines indicate mean concentrations, vertical lines indicate 95% CI, and dotted lines indicate patients with missing data. Graphs show cystatin C level after CT in N-acetylcysteine (C) and control (D) groups. Dashed line indicates maximum normal value of cystatin C (1.55 mg/L). Triangles indicate patients in whom cystatin C values were not obtained at both day 2 and day 4.

 

Figure 4
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  		Fig. 1D —Time evolution of markers of glomerular filtration rate in each patient. Thick horizontal lines indicate mean concentrations, vertical lines indicate 95% CI, and dotted lines indicate patients with missing data. Graphs show cystatin C level after CT in N-acetylcysteine (C) and control (D) groups. Dashed line indicates maximum normal value of cystatin C (1.55 mg/L). Triangles indicate patients in whom cystatin C values were not obtained at both day 2 and day 4.

 

Figure 5
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  		Fig. 2A —Scatterplots show relative increase in creatinine and cystatin C concentrations from baseline (day 0). Two usual thresholds (25% and 50%) are depicted for both markers. Points on diagonal have equal increase for both markers. Graphs show increase for N-acetylcysteine group on day 2 (A) and day 4 (B) after CT.

 

Figure 6
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  		Fig. 2B —Scatterplots show relative increase in creatinine and cystatin C concentrations from baseline (day 0). Two usual thresholds (25% and 50%) are depicted for both markers. Points on diagonal have equal increase for both markers. Graphs show increase for N-acetylcysteine group on day 2 (A) and day 4 (B) after CT.

 

Figure 7
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  		Fig. 2C —Scatterplots show relative increase in creatinine and cystatin C concentrations from baseline (day 0). Two usual thresholds (25% and 50%) are depicted for both markers. Points on diagonal have equal increase for both markers. Graphs show increase for control group on day 2 (C) and day 4 (D) after CT.

 

Figure 8
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  		Fig. 2D —Scatterplots show relative increase in creatinine and cystatin C concentrations from baseline (day 0). Two usual thresholds (25% and 50%) are depicted for both markers. Points on diagonal have equal increase for both markers. Graphs show increase for control group on day 2 (C) and day 4 (D) after CT.

 

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