N-acetylcysteine infusion reduces the resistance index of renal artery in the early stage of systemic sclerosis.
OBJECTIVE
To evaluate resistance index (RI) changes in renal artery after N-acetylcysteine infusion in patients with systemic sclerosis.


METHODS
In an open-label study 40 patients with systemic sclerosis (SSc) were treated with N-acetylcysteine (NAC) iv infusion over 5 consecutive hours, at a dose of 0.015 g x kg(-1) x h(-1). Renal haemodynamic effects were evaluated by color Doppler examination before and after NAC infusion.


RESULTS
NAC infusion significantly reduced RI in a group of sclerodermic patients with early/active capillaroscopic pattern, modified Rodnan Total Skin Score (mRTSS) <14 and mild-moderate score to the vascular domain of Medsger Scleroderma Disease Severity Scale (DSS). RI increased after NAC infusion in patients with late capillaroscopic pattern, mTRSS>14 and severe-end stage score to the vascular domain of DSS. In patients with reduction of RI after NAC infusion, diffusion capacity for carbon monoxide mean value was significantly higher than in those patients with an increase of RI. No significant differences in renal blood flow were found between patients with different subsets of SSc.


CONCLUSIONS
In patients with low disease severity NAC ameliorates vascular renal function.
Rosato
Edoardo
E
Sapienza University of Rome Department of Clinical Medicine, Clinical Immunology Unit-Scleroderma Center, Italy.
Cianci
Rosario
R
Barbano
Biagio
B
Menghi
Ginevra
G
Gigante
Antonietta
A
Rossi
Carmelina
C
Zardi
Enrico M
EM
Amoroso
Antonio
A
Pisarri
Simonetta
S
Salsano
Felice
F
D000111:Acetylcysteine / Q000627:therapeutic use*; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D020678:Microscopic Angioscopy; D008875:Middle Aged; D012077:Renal Artery / Q000187:drug effects / Q000502:physiology; D012078:Renal Artery Obstruction / Q000188:drug therapy* / Q000503:physiopathology; D012595:Scleroderma, Systemic / Q000150:complications* / Q000503:physiopathology; D014655:Vascular Resistance / Q000187:drug effects
D016166:Free Radical Scavengers; D000111:Acetylcysteine