N-acetylcysteine improves residual renal function in peritoneal dialysis patients: a pilot study.
BACKGROUND
Preservation of peritoneal membrane function and residual renal function is important for the optimal care of peritoneal dialysis patients. N-Acetylcysteine may ameliorate oxidative stress, which is thought to be involved in peritoneal membrane dysfunction. In addition, N-acetylcysteine may have a positive effect on renal function in the setting of nephrotoxic contrast media administration. The aim of this study was to investigate the effect of N-acetylcysteine on peritoneal and residual renal function in peritoneal dialysis patients.


METHODS
Ten prevalent peritoneal dialysis patients were administered oral N-acetylcysteine 1200 mg twice daily for 4 weeks. At baseline and at the end of treatment, peritoneal membrane function and residual renal function were assessed using a 4.25% dextrose peritoneal equilibration test and 24-hour dialysate and urine collection for calculation of peritoneal and residual renal Kt/V and mean urea and creatinine residual renal clearance.


RESULTS
No significant changes were demonstrated in peritoneal membrane function, including dialysate-to-plasma creatinine ratio, sodium sieving, and net ultrafiltration. Residual renal function improved significantly: urine volume increased from 633 ± 426 to 925 ± 552 mL/24 hours (p = 0.022), residual renal Kt/V increased from 0.56 ± 0.41 to 0.75 ± 0.47 (p = 0.037), and mean residual urea and creatinine clearance increased from 4.96 ± 3.96 to 5.95 ± 4.08 mL/min/1.73 m(2) (p = 0.059).


CONCLUSIONS
N-acetylcysteine may improve residual renal function in patients treated with peritoneal dialysis.
Feldman
Leonid
L
Nephrology Division, Assaf Harofeh Medical Center, Zerifin, Israel. leonidf@asaf.health.gov.il
Shani
Michal
M
Efrati
Shai
S
Beberashvili
Ilia
I
Yakov-Hai
Iris
I
Abramov
Elena
E
Sinuani
Inna
I
Rosenberg
Roza
R
Weissgarten
Joshua
J
D000111:Acetylcysteine / Q000008:administration & dosage / Q000493:pharmacokinetics / Q000494:pharmacology*; D000368:Aged; D003404:Creatinine / Q000378:metabolism; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000503:physiopathology* / Q000628:therapy; D007677:Kidney Function Tests; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D010530:Peritoneal Dialysis; D010865:Pilot Projects; D011446:Prospective Studies; D014556:Urine
D003404:Creatinine; D000111:Acetylcysteine