N-acetylcysteine ameliorates amphotericin-induced nephropathy in rats.
BACKGROUND
Amphotericin B may cause acute reduction in renal function. N-acetylcysteine (NAC) has a renoprotective activity in several nephrotoxic renal insults, but its effect on amphotericin-induced renal failure has not been investigated yet.


METHODS
Acute renal failure was induced in 30 Sprague-Dawley rats by a single intraperitoneal injection of amphotericin B (50 mg/kg). NAC (10 mg/kg) in isotonic saline or isotonic saline alone were administered daily for 4 days, starting 1 day before the amphotericin B injection. Glomerular filtration rate (GFR) was assessed using 99m-technetium diethylene triaminepentaacetic acid. Before and following amphotericin B administration, a 24-hour urine collection was performed for sodium, potassium and magnesium determination. The kidneys were preserved for pathologic examination.


RESULTS
Amphotericin B induced a significant decrease of GFR in both groups. Four days after amphotericin injection the GFR in the NAC-treated group was significantly higher than in the control group (0.62 +/- 0.20 vs. 0.46 +/- 0.14 ml/min, p = 0.042). Histologic signs of acute tubular necrosis were attenuated in the NAC-treated group. There were no significant differences between the groups in sodium, potassium and magnesium urine excretion after amphotericin injection.


CONCLUSIONS
NAC treatment exerted a renoprotective effect on deterioration of GFR in a rat model of amphotericin-induced renal failure. No functional protection on tubular function, as obviated by similar polyuria and urine losses of potassium and magnesium in both groups, was observed.
Feldman
Leonid
L
Nephrology Division, Assaf Harofeh Medical Center (affiliated to Sackler Faculty of Medicine, Tel Aviv University), Zerifin, Israel. leonidf@asaf.health.gov.il <leonidf@asaf.health.gov.il>
Efrati
Shai
S
Dishy
Victor
V
Katchko
Leonid
L
Berman
Sylvia
S
Averbukh
Michael
M
Aladjem
Mordechai
M
Averbukh
Zhan
Z
Weissgarten
Joshua
J
D000666:Amphotericin B; D000818:Animals; D004195:Disease Models, Animal; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D007674:Kidney Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology*; D008297:Male; D051381:Rats; D017207:Rats, Sprague-Dawley; D016896:Treatment Outcome
D000666:Amphotericin B