Publication: Renoprotective effect of high dose n-acetylcysteine in patients who underwent cardiac surgery
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Date
2022
Authors
Yin, Gan Shee
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Abstract
Background: The effect of N-acetylcysteine on the prevention of acute kidney injury post-cardiac surgery remains controversial. This study was designed to evaluate the effect of high-dose N-acetylcysteine on the renal function of patients who underwent cardiac surgery. Methods: A comparative cross-sectional study involving retrospective record review (January 2017-December 2021) was conducted at Hospital Universiti Sains Malaysia. One hundred and twenty-three adult patients underwent cardiac surgery with cardiopulmonary bypass and had at least 1 of the following: pre-existing renal dysfunction or recent contrast less than six weeks from the operation date were recruited. The study group (n=40) received T N-acetylcysteine 600mg BD one-day prior to operation and IV N-acetylcysteine 10g into cardiopulmonary bypass machine, and the control group (n=83) did not receive N-acetylcysteine. We measured the mean serum creatinine level at 24 hours and 48 hours postoperatively and compared the prevalence of acute kidney injury using KDIGO criteria between both groups. Results: There was no significant difference in comparing the mean values of serum creatinine and estimated glomerular filtration rate (eGFR) across the pre-operation, 24 hours and 48 hours postoperatively between the N-acetylcysteine 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 hospitalisation (p>0.05). Conclusion: In this study, we did not detect statistically significant protection of renal function in patients who received N-acetylcysteine for cardiac surgery. A further randomised controlled trial in this area is needed to minimise confounding factors
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Keywords
N-acetylcysteine , renal dysfunction