title: Effects of N-acetyl cysteine on renal functions evaluated by blood neutrophil gelatinase-associated lipocalin levels in geriatric patients undergoing coronary artery bypass grafting.
abstract: OBJECTIVE
  Recent conflicting studies on the renal effects of N-acetyl cysteine (NAC) after cardiac surgery have been published. The aim of this study was to evaluate the renal effects of NAC using neutrophil gelatinase-associated lipocalin (NGAL) blood levels in elderly patients undergoing coronary artery bypass grafting (CABG).
  
  
  METHODS
  This randomized, double-blinded, placebo-controlled study was conducted among geriatric patients (>65 years) scheduled to undergo CABG. A total of 60 consecutive patients were randomly assigned to 2 groups. The first group received I.V. NAC (n=30) and the second group received placebo (n=30) at induction of anesthesia and then for 20 h. NGAL values were determined and conventional renal function tests were performed. Statistical analysis was performed using SPSS 17.0 (IL, Chicago, USA). A p value of <0.05 was considered statistically significant.
  
  
  RESULTS
  Plasma creatinine levels at 24 h postoperatively were significantly higher in the placebo group than in the NAC group (1.41±0.63 vs. 1.13±0.35; p<0.05). The mean serum NGAL levels at 3 h postoperatively were higher in the placebo group than in the NAC group (104.94±30.51 vs. 87.82±25.18; p<0.05). NGAL levels were similar between the groups at all other measurement time points. Plasma creatinine levels of ≥1.5 mg/dL or >25% of the baseline value at any time during the study period were observed in 27% of patients in the NAC group and 37% of patients in the placebo group; the difference was statistically significant (p<0.05).
  
  
  CONCLUSIONS
  In the present study, we found that I.V. NAC infusion in elderly patients undergoing CABG reduced the incidence of acute kidney injury as determined by blood NGAL and creatinine levels.
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Kocatepe University, Afyonkarahisar-Turkey. draldemir@yahoo.com.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Aldemir
authors.affiliation: Department of Clinical Biochemistry, Faculty of Medicine, Kocatepe University, Afyonkarahisar-Turkey.
authors.forename: Halit Buğra
authors.initials: HB
authors.lastname: Koca
authors.affiliation: Department of Anesthesiology and Reanimation, Faculty of Medicine, Kocatepe University, Afyonkarahisar-Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Doğan Bakı
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Kocatepe University, Afyonkarahisar-Turkey.
authors.forename: Görkem
authors.initials: G
authors.lastname: Çarşanba
authors.affiliation: Department of Anesthesiology and Reanimation, Antalya Education and Research Hospital, Antalya-Turkey.
authors.forename: Nilgün
authors.initials: N
authors.lastname: Öztürk Kavrut
authors.affiliation: Department of Anesthesiology and Reanimation, Antalya Education and Research Hospital, Antalya-Turkey.
authors.forename: Ali Sait
authors.initials: AS
authors.lastname: Kavaklı
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Kocatepe University, Afyonkarahisar-Turkey.
authors.forename: Fahri
authors.initials: F
authors.lastname: Adalı
authors.affiliation: Department of Cardiovascular Surgery, Antalya Education and Research Hospital, Antalya-Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Emmiler
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Kocatepe University, Afyonkarahisar-Turkey.
authors.forename: Osman Tansel
authors.initials: OT
authors.lastname: Darçın