Nephroprotective Effects of Post-contrast N-Acetylcysteine and Montelukast Treatment in a Rat Model of Contrast-induced Acute Kidney Injury.

Abstract

Contrast-induced acute kidney injury (CI-AKI) is an important complication of iodinated contrast exposure in which oxidative stress and inflammatory processes contribute to renal damage. This study established an experimental rat model of CI-AKI and examined the effects of treatment initiated after contrast administration with N-acetylcysteine (NAC), montelukast, or a combination of both. Adult male Wistar rats underwent water deprivation followed by sequential intravenous administration of Nω-nitro-L-arginine methyl ester (L-NAME), indomethacin, and iohexol. Treatment was initiated 1 h after completion of iohexol administration, approximately 1.5 h after L-NAME administration, and was continued once daily for 3 consecutive days. Renal function indices, oxidative stress parameters, inflammatory cytokines, renal injury biomarkers, and kidney histopathology were evaluated. The untreated CI-AKI group exhibited pronounced renal dysfunction, an unfavorable oxidative stress and inflammatory profile, and substantial histopathological damage. Compared with the untreated CI-AKI group, animals receiving NAC, montelukast, or the combined regimen generally showed improved biochemical and histopathological findings. Glutathione (GSH) levels were highest, and mean histopathological injury scores were numerically lowest in the combination group; however, combined treatment did not consistently outperform monotherapy across the assessed outcomes. This protocol provides a controlled preclinical framework for evaluating post-contrast interventions in CI-AKI, and the findings warrant further experimental investigation of NAC and montelukast without establishing clinical efficacy or a combination-specific advantage.