title: Intravenous administration of N-acetylcysteine reduces plasma total homocysteine levels in renal transplant recipients.
abstract: BACKGROUND
  Hyperhomocysteinemia occurs in approximately 60-70% of renal transplant recipients and is associated with increased risk of cardiovascular events, mortality and kidney allograft loss. In normal subjects N-acetylcysteine (NAC) given either orally or intravenously markedly reduces plasma total homocysteine (tHcy) level. In cardiac transplant recipients it was reported, that oral treatment with NAC does not affect Hcy levels. We have therefore, investigated the effect of intravenous NAC on plasma tHcy levels in renal transplant recipients.
  
  
  METHODS
  Eleven renal transplant recipients who had normal plasma levels of vitamin B12 and folic acid, were treated with intravenous NAC or placebo in a crossover manner.
  
  
  RESULTS
  Intravenous administration of NAC significantly reduced plasma tHcy (p=0.0008). Decrease in tHcy was related to its initial concentration.
  
  
  CONCLUSIONS
  Intravenous NAC profoundly reduces tHcy level in renal transplant recipients. Further research is needed to establish the effect of orally administered NAC on plasma homocysteine concentration in this clinical condition.
authors.affiliation: Department of Internal Medicine & Nephrology, CSK MSWiA, Warsaw, Poland.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Rymarz
authors.forename: Marek
authors.initials: M
authors.lastname: Durlik
authors.forename: Andrzej
authors.initials: A
authors.lastname: Rydzewski
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D000328:Adult; D000704:Analysis of Variance; D003404:Creatinine / Q000097:blood; D018592:Cross-Over Studies; D005260:Female; D016231:Fluorescence Polarization Immunoassay; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000188:drug therapy* / Q000209:etiology*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D018579:Patient Selection
chemical_list: D006710:Homocysteine; D003404:Creatinine; D000111:Acetylcysteine