Effect of N-Acetylcysteine on hsCRP in Patients on Continues Ambulatory Peritoneal Dialysis: A Quasi-Experimental Study

Abstract

Background: Inflammatory processes are proved in patients with chronic kidney disease (CKD) as one of the leading causes of mortality and morbidity. N-acetylcysteine (NAC) is known as an antioxidant drug with anti-inflammatory effects. Objectives: This study aimed to evaluate the effects of NAC on hsCRP in CKD patients on peritoneal dialysis. Methods: This quasi-experimental self-controlled study examined adult CKD patients on peritoneal dialysis referred to the peritoneal dialysis clinic. The participants were assigned into two groups (A: CRP of 5 - 15 mg/L and B: CRP < 5 mg/L), and both groups were treated with oral NAC 600mg twice a day for eight weeks. First, the hsCRP was measured before and after the intervention, and then all the collected data were analyzed. Results: Forty patients (n = 24 in the group A and n = 26 in the group B) participated in this study. NAC decreased the hsCRP level in both groups (P = 0.001 in the group A vs. P = 0.002 in group B); however, the decrease was more prominent in the group A (P = 0.013). The hsCRP decrease was more significant in women (P = 0.002) in general and women in the group B (P = 0.02) in particular. The hsCRP variation had a significant relationship with the underlying disease (P = 0.009). There was no significant correlation between the hsCRP variation with age (r = -0.173, P = 0.285) and the duration of dialysis. Conclusions: The administration of NAC (600 mg, twice a day for eight weeks) significantly decreased the level of hsCRP in patients on peritoneal dialysis, especially in those with CRP = 5 - 15 mh/L. The decrease has no relationship with age and duration of dialysis; however, it was more highlighted in women.

Prognostic Factors of In-Hospital Mortality in Adult Patients With Aluminum Phosphide (ALP) Poisoning in Southern Iran (2014-2018)

“…Castor oil, NAC, and magnesium sulfate (MgSO 4 ) were the most frequent treatment in patients with ALP poisoning. Large amounts of sodium bicarbonate (NaHCO 3 ) are recommended for correction of acidosis in ALP poisoned patients, but there is some controversy about its effectiveness [12,13,30,45]. We found that taking sodium bicarbonate (NaHCO 3 ) in ALP poisoned patients is one of the main prognostic factors for in-hospital mortality.…”

N-Acetylcysteine: more than preventing contrast-induced nephropathy in uremic patients—focus on the antioxidant and anti-inflammatory properties

“…A placebo-controlled study in PD patients found that oral intake of 600 mg of NAC twice daily for 8 weeks resulted in decreased plasma levels of IL-6 compared to controls [ 117 ]. Similarly, the administration of oral NAC significantly decreased hs-CRP levels in PD patients; this anti-inflammatory effect was more pronounced in patients with increased inflammatory status at baseline (CRP levels between 5 and 15 mg/L) [ 118 ]. Another placebo-controlled trial also examined the effect of NAC on inflammation status of chronic ambulatory PD subjects demonstrating that oral NAC administration (600 mg of NAC twice daily for 8 weeks) reduced the levels of several inflammatory biomarkers; interleukin 1 (IL-1), IL-6, hs-CRP, procalcitonin, complement C3, TNF-a and soluble intercellular adhesion molecule-1 (SICAM-1) [ 6 ].…”