Ascorbic Acid Does Not Lower Contrast-Induced Nephropathy Risk
Ascorbic acid has no significant effect on the incidence of contrast-induced nephropathy (CIN) among patients undergoing coronary angiography, researchers reported in Therapeutic Apheresis and Dialysis (2013;17:384-390). It may, however, still have a protective role in CIN.
Benjamin Dvoršak, MD, of the University Clinical Center Maribor, Maribor, Slovenia, and colleagues studied 81 patients undergoing coronary angiography, randomly assigned 40 to receive ascorbic acid, which has antioxidant activity, and 41 to receive placebo before the procedure. All patients also received intravenous volume expansion with normal saline before the procedure. The researchers defined CIN as a greater than 25% increase in serum creatinine level from baseline measured three to four days after the procedure.
CIN occurred in two patients (3%) in the ascorbic acid group and three (7.3%) of the placebo group, a non-significant difference between the groups. Post-procedural rises in serum creatinine level, however, occurred significantly less frequently in the ascorbic acid than the placebo group (12.3% vs. 23.4%).
Earlier this year, researchers in Saudi Arabia reported on a prospective study showing that adding either ascorbic acid, N-acetylcysteine, or a combination of the two to saline hydration was no more beneficial in preventing CIN than a saline hydration alone. The study, published in the Journal of Interventional Cardiology (2013;26:90-96), included 243 patients undergoing coronary angiography.