Renoprotective effect of highdose N-Acetylcysteine in patients who underwent cardiac surgery: an observational study

Abstract

Background: The effect of N-acetylcysteine (NAC) on the prevention of acute kidney injury postcardiac surgery remains controversial. This study was designed to evaluate the effect of highdose NAC on the renal function of patients who underwent cardiac surgery. Materials and Methods: A comparative cross-sectional study involving retrospective record review. One hundred and twenty-three adult patients who underwent cardiac surgery with cardiopulmonary bypass (CPB) were recruited. The study group (n = 40) received NAC 600 mg tablets a day prior to surgery and intravenous NAC 10 g into the CPB machine, and the control group (n = 83) did not receive any supplemental NAC. We evaluated the mean serum creatinine level at 24 and 48 h postoperatively and compared the prevalence of acute kidney injury using Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Results: There was no significant difference between serum creatinine and estimated glomerular filtration rate (eGFR) across the preoperation, 24, and 48 h postoperatively between the NAC and control groups (P > 0.05). There was no significant difference in the prevalence of acute kidney injury between the two groups (58 [47.2%] vs. 37 [44.6%]; P = 0.41). No difference was observed in the two groups’ need for renal replacement therapy, duration of ventilation, length of stay in the intensive care unit, and duration of hospitalization (P > 0.05). Conclusion: In this study, we did not detect statistically significant protection of renal function in patients who received NAC for cardiac surgery. A further randomized controlled trial in this area is needed to minimize confounding factors.

Keywords

• acute kidney injury
• cardiac surgery
• highdose
• n-acetylcysteine
• renal dysfunction