title: N-acetylcysteine reduces the renal oxidative stress and apoptosis induced by hemorrhagic shock.
abstract: Renal ischemia/reperfusion injury induced by hemorrhagic shock (HS) and subsequent fluid resuscitation is a common cause of acute renal failure. The objective of this study was to evaluate the effect of combining N-acetylcysteine (NAC) with fluid resuscitation on renal injury in rats that underwent HS.
  
  
  
  Two groups of male Wistar rats were induced to controlled HS at 35 mm Hg mean arterial pressure for 60 min. After this period, the HS and fluid resuscitation (HS/R) group was resuscitated with lactate containing 50% of the blood that was withdrawn. The HS/R + NAC group was resuscitated with Ringer's lactate combined with 150 mg/kg of NAC and blood. The sham group animals were catheterized but were not subjected to shock. All animals were kept under anesthesia and euthanized after 120 min of fluid resuscitation or observation.
  
  
  
  Animals treated with NAC presented attenuation of histologic lesions, reduced oxidative stress, and apoptosis markers when compared with animals from the HS/R group. The serum creatinine was similar in all the groups.
  
  
  
  NAC is a promising drug for combining with fluid resuscitation to attenuate the kidney injury associated with HS.
authors.affiliation: Department of Surgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: Miriam Aparecida
authors.initials: MA
authors.lastname: Moreira
authors.affiliation: Hypertension Unit, Heart Institute, University of Sao Paulo Medical School, São Paulo, São Paulo, Brazil.
authors.forename: Maria Claudia
authors.initials: MC
authors.lastname: Irigoyen
authors.affiliation: Medical School, Federal University of Vale do São Francisco, Petrolina, Pernambuco, Brazil.
authors.forename: Karen Ruggeri
authors.initials: KR
authors.lastname: Saad
authors.affiliation: Medical School, Federal University of Vale do São Francisco, Petrolina, Pernambuco, Brazil.
authors.forename: Paulo Fernandes
authors.initials: PF
authors.lastname: Saad
authors.affiliation: Department of Internal Medicine, Emergency Medicine Laboratory (LIM-51), University of São Paulo Medical School, São Paulo, São Paulo, Brazil.
authors.forename: Marcia Kiyomi
authors.initials: MK
authors.lastname: Koike
authors.affiliation: Department of Surgery, Laboratory of Surgical Physiopathology (LIM-62), University of São Paulo Medical School, São Paulo, São Paulo, Brazil. Electronic address: edna.montero@gmail.com.
authors.forename: Edna Frasson de Souza
authors.initials: EF
authors.lastname: Montero
authors.affiliation: Department of Surgery, Federal University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: José Luiz
authors.initials: JL
authors.lastname: Martins
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology / Q000627:therapeutic use*; D058186:Acute Kidney Injury / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D000818:Animals; D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use*; D017209:Apoptosis / Q000187:drug effects; D015415:Biomarkers / Q000378:metabolism; D003131:Combined Modality Therapy; D005440:Fluid Therapy; D008297:Male; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D015427:Reperfusion Injury / Q000209:etiology / Q000378:metabolism / Q000628:therapy*; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000150:complications* / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D015415:Biomarkers; D000111:Acetylcysteine
keywords: Acetylcysteine; Apoptosis; Hemorrhagic shock; Oxidative stress; Rats; Renal insufficiency