Comparison of the effects of N-acetyl cysteine and erdosteine in rats with renal injury caused by paracetamol intoxication.
OBJECTIVE
The aim of the present study was to investigate the therapeutic and preventive effects of N-acetyl cysteine and erdosteine on renal injury associated with paracetamol (acetaminophen) intoxication.


METHODS
Female albino Wistar rats were divided into six groups: control; paracetamol (1 g/kg, oral); paracetamol (1 g/kg, oral) + erdosteine (150 mg/kg/day, oral); paracetamol (1 g/kg, oral) + N-acetyl cysteine (140 mg/kg bolus, followed by 70 mg/kg, oral); N-acetyl cysteine control (140 mg/kg bolus, followed by 70 mg/kg, oral); and erdosteine control (150 mg/kg/day, oral). Potential renal injury was assessed using biochemical analyses, radionuclide imaging, and histopathological parameters.


RESULTS
In the paracetamol group, blood urea nitrogen and creatinine levels were significantly increased compared with controls. Histopathological examination showed tubular vacuolization, tubular necrosis, and remarkable interstitial inflammation. The excretion function was observed to be insufficient on radionuclide imaging. However, in the groups treated with erdosteine or N-acetyl cysteine after paracetamol, biochemical analyses, radionuclide imaging, and histopathological parameters showed significantly less evidence of renal toxicity than that observed in the group receiving paracetamol alone. Less renal toxicity was detected in rats receiving N-acetyl cysteine than in those receiving erdosteine.


CONCLUSIONS
Renal injury may develop after paracetamol overdose. Erdosteine and N-acetyl cysteine are both effective in the prevention of renal injury when given in the early phase of paracetamol nephrotoxicity. N-acetyl cysteine is more protective than erdosteine.
Department of Emergency Medicine, Faculty of Medicine, Duzce University, Duzce, Turkey. hayatikandis@yahoo.com
Hayati
H
Kandiş
Melih Engin
ME
Erkan
Umran
U
Yildirim
Harun
H
Güneş
Mesut
M
Erbaş
Hayriye A K
HA
Yildirim
Suat
S
Gezer
Ismail Hamdi
IH
Kara
D000082:Acetaminophen / Q000633:toxicity*; D000111:Acetylcysteine / Q000008:administration & dosage / Q000627:therapeutic use*; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000378:metabolism / Q000517:prevention & control*; D000818:Animals; D000975:Antioxidants / Q000008:administration & dosage / Q000627:therapeutic use*; D003627:Data Interpretation, Statistical; D005260:Female; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology; D007677:Kidney Function Tests; D011877:Radionuclide Imaging; D051381:Rats; D017208:Rats, Wistar; D013864:Thioglycolates / Q000008:administration & dosage / Q000627:therapeutic use*; D013876:Thiophenes / Q000008:administration & dosage / Q000627:therapeutic use*
D000975:Antioxidants; D013864:Thioglycolates; D013876:Thiophenes; D000082:Acetaminophen; C048498:erdosteine; D000111:Acetylcysteine