The effect of N-acetyl cysteine injection on renal function after coronary artery bypass graft surgery: a randomized double blind clinical trial

Abstract

Background This study aimed to compare the effects of N-acetyl cysteine on renal function after coronary artery bypass graft surgery. Methods In this randomized clinical trial conducted in Golestan Hospital, Ahvaz, Iran, 60 candidates for coronary artery bypass graft surgery were selected and divided into two N-acetyl cysteine and control groups (30 people each). Patients received 3 (2 intraoperative and 1 postoperative) doses of IV N-acetyl cysteine (100 mg/kg) (n = 30) or placebo (n = 30) over 24 h. Prescription times were as follows: after induction of anesthesia, in the Next 4 h, and in the 16 h after on. Primary outcomes were serum levels of BUN and Cr, at baseline,4 and 48 h after surgery. And also need renal replacement therapy (RRT). Secondary outcomes included the hemodynamic variables, Blood products transfusion. Results There were significant differences in BUN between groups at 4 h (P = 0.02) and 48 h after surgery (P = 0.001) There were significant differences in Cr level between groups at 4 h (P < 0.001) and 48 h after surgery (P = 0.001). MAP at different times (at 4 h p = 0.002 and 48 h after surgery P < 0.001) were significantly different between the two groups. There was a significant difference between the two groups in terms of the unit of Packed cell transfusion (P = 0.002) and FFP transfusion (P < 0.001). Conclusion In the present study, we found that administration of N-acetyl cysteine can reduce the incidence of acute kidney injury in patients undergoing coronary artery bypass graft surgery and improved kidney functions. Trial registry IRCT20190506043492N3 Registered at 2020.06.07.

Regulatory Effects of Astragaloside IV on Hyperglycemia-Induced Mitophagy in Schwann Cells

“…However, whether AS-IV has a direct protective effect on SCs remains unclear. NAC can be used as a common antioxidant agent due to its free radical scavenging activity [ 39 ]. Therefore, we used NAC as a control to observe the therapeutic efficacy of AS-IV.…”

Raloxifene Protects Cisplatin-Induced Renal Injury in Mice via Inhibiting Oxidative Stress

“…Javaherforooshzadeh F found that administration of N-acetylcysteine can reduce the incidence of acute kidney injury in patients treated coronary artery bypass graft surgery and promoted kidney functions. 33 However, another study indicated that when evaluated in patients with stage 3 chronic kidney disease, 600 mg oral NAC supplementation was not able to alter serum creatinine or Cystatin C. 34 Lastly, there is the debate regarding NAC efficacy with kidney disease. Both SOD and CAT are antioxidant enzyme in the body.…”

Changing Perspectives from Oxidative Stress to Redox Signaling—Extracellular Redox Control in Translational Medicine

“…It also shows beneficial outcomes after surgery. It was shown to decrease the incidence of acute kidney injury (AKI) after heart surgery [182] and prevented changes related to oxidative stress in routine arthroscopic knee surgery [183]. NAC ingestion followed by hyperoxia showed increased levels of erythropoietin, an effect that was not seen in the group only exposed to hyperoxia [184].…”