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MESNA (Sodium 2-mercaptoethanesulfonate) for Prevention of Contrast Medium-Induced Nephrotoxicity - Controlled Trial

MESNA (Sodium 2-mercaptoethanesulfonate) for Prevention of Contrast Medium-Induced Nephrotoxicity - Controlled Trial

U Ludwig, M K Riedel, M Backes, A Imhof, R Muche, F Keller

Clin Nephrol. 2011 Apr;75(4):302-8.

PMID: 21426884

Abstract:

Background:
The purpose of this study was to examine the efficacy of sodium 2-mercaptoethanesulfonate (MESNA), a reactive oxygen scavenger, in at-risk patients given radiographic contrast agents. Contrast-induced nephropathy (CIN) is a common complication of radiographic procedures; reactive oxygen species (ROS) could play a key role.
Methods:
We conducted a randomized, double-blinded, placebo-controlled trial in 100 patients with stable serum creatinine levels ≥ 150 µmol/l. They received an infusion of either 1,600 mg of MESNA (n = 51) or placebo (n = 49) plus 0.9% saline prior to and after contrast administration. CIN was defined as a ≥ 25% increase in serum creatinine after 48 h compared to baseline.
Results:
CIN occurred in 7 patients in the placebo group and none in the MESNA group (p = 0.005). The adjusted odds ratio for CIN was 0.17 (95% confidence interval 0.03 - 0.80, p = 0.026) in the MESNA group compared to the placebo group. Cystatin C concentrations decreased slightly in the MESNA group but increased in the control group (p < 0.05).
Conclusion:
MESNA plus volume expansion before and during contrast exposure was effective in this single-center study for preventing CIN compared to volume expansion alone.

Chemicals Related in the Paper:

Catalog Number	Product Name	Structure	CAS Number	Price
AP19767454-A	Sodium 2-mercaptoethanesulfonate		19767-45-4	Price

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