High Dose of N-Acetylcystein Prevents Acute Kidney Injury in Chronic Kidney Disease Patients Undergoing Myocardial Revascularization

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art_SANTANA-SANTOS_High_Dose_of_N_Acetylcystein_Prevents_Acute_Kidney_2014.PDF (373.4 KB)
Citações na Scopus
30
Tipo de produção
article
Data de publicação
2014
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER SCIENCE INC
Autores
Citação
ANNALS OF THORACIC SURGERY, v.97, n.5, p.1617-1623, 2014
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background. The renoprotective effect of N-acetylcystein in patients undergoing coronary artery bypass graft surgery is controversial. Methods. We assessed the renoprotective effect of the highest dose of N-acetylcystein sanctioned for clinical use in a prospective, double-blind, placebo-controlled study including 70 chronic kidney disease patients, stage 3 or 4, who underwent coronary artery bypass graft surgery, on cardiopulmonary bypass (CPB) and off CPB, and were randomly allocated to receive either N-acetylcystein 150 mg/kg followed by 50 mg/kg for 6 hours in 0.9% saline or only 0.9% saline. Acute kidney injury was defined by the Acute Kidney Injury Network classification. Results. The incidence of kidney injury was reduced in the N-acetylcystein group (57.1% versus 28.6%, p = 0.016). Nonuse of N-acetylcystein (relative risk 3.58, 95% confidence interval: 1.04 to 12.33, p = 0.04) and cardiopulmonary bypass (relative risk 4.55, 95% confidence interval: 1.28 to 16.15, p = 0.02) were independent predictors of kidney injury. In patients treated with CPB, N-acetylcystein reduced the incidence of kidney injury from 63% to 46%. Oxidative stress was increased in control subjects (p = 0.01) and abolished in patients receiving N-acetylcystein. Conclusions. Maximum intravenous doses of N-acetylcystein reduce the incidence of acute kidney injury in patients with kidney disease undergoing coronary artery bypass graft surgery, abolish oxidative stress, and mitigate the negative effect of CPB on renal function. (C) 2014 by The Society of Thoracic Surgeons
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URI
https://observatorio.fm.usp.br/handle/OPI/7411
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - FM/MCM
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/08
Artigos e Materiais de Revistas Científicas - LIM/09
Artigos e Materiais de Revistas Científicas - LIM/11
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