title: N-acetylcysteine protects against star fruit-induced acute kidney injury.
abstract: Star fruit (SF) is a popular fruit, commonly cultivated in many tropical countries, that contains large amount of oxalate. Acute oxalate nephropathy and direct renal tubular damage through release of free radicals are the main mechanisms involved in SF-induced acute kidney injury (AKI). The aim of this study was to evaluate the protective effect of N-acetylcysteine (NAC) on SF-induced nephrotoxicity due to its potent antioxidant effect.
  
  
  
  Male Wistar rats received SF juice (4 mL/100 g body weight) by gavage after a 12 h fasting and water deprivation. Fasting and water deprivation continued for 6 h thereafter to warrant juice absorption. Thereafter, animals were allocated to three experimental groups: SF (n = 6): received tap water; SF + NAC (n = 6): received NAC (4.8 g/L) in drinking water for 48 h after gavage; and Sham (n = 6): no interventions. After 48 h, inulin clearance studies were performed to determine glomerular filtration rate. In a second series of experiment, rats were housed in metabolic cages for additional assessments.
  
  
  
  SF rats showed markedly reduced inulin clearance associated with hyperoxaluria, renal tubular damage, increased oxidative stress and inflammation. NAC treatment ameliorated all these alterations. Under polarized light microscopy, SF rats exhibited intense calcium oxalate birefringence crystals deposition, dilation of renal tubules and tubular epithelial degeneration, which were attenuate by NAC therapy.
  
  
  
  Our data show that therapeutic NAC attenuates renal dysfunction in a model of acute oxalate nephropathy following SF ingestion by reducing oxidative stress, oxaluria, and inflammation. This might represent a novel indication of NAC for the treatment of SF-induced AKI.
authors.affiliation: a Department of Nephrology, School of Medicine , University of São Paulo , São Paulo , Brazil.
authors.forename: Maria Heloisa Massola
authors.initials: MH
authors.lastname: Shimizu
authors.affiliation: a Department of Nephrology, School of Medicine , University of São Paulo , São Paulo , Brazil.
authors.forename: Pedro Henrique França
authors.initials: PH
authors.lastname: Gois
authors.affiliation: a Department of Nephrology, School of Medicine , University of São Paulo , São Paulo , Brazil.
authors.forename: Rildo Aparecido
authors.initials: RA
authors.lastname: Volpini
authors.affiliation: a Department of Nephrology, School of Medicine , University of São Paulo , São Paulo , Brazil.
authors.forename: Daniele
authors.initials: D
authors.lastname: Canale
authors.affiliation: a Department of Nephrology, School of Medicine , University of São Paulo , São Paulo , Brazil.
authors.forename: Weverton Machado
authors.initials: WM
authors.lastname: Luchi
authors.affiliation: b Nephrology Division , Federal University of São Paulo , São Paulo , Brazil.
authors.forename: Leila
authors.initials: L
authors.lastname: Froeder
authors.affiliation: b Nephrology Division , Federal University of São Paulo , São Paulo , Brazil.
authors.forename: Ita Pfeferman
authors.initials: IP
authors.lastname: Heilberg
authors.affiliation: a Department of Nephrology, School of Medicine , University of São Paulo , São Paulo , Brazil.
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Seguro
mesh_terms: D000111:Acetylcysteine / Q000494:pharmacology*; D058186:Acute Kidney Injury / Q000139:chemically induced / Q000188:drug therapy*; D000818:Animals; D000975:Antioxidants / Q000494:pharmacology*; D065826:Averrhoa / Q000009:adverse effects*; D003404:Creatinine / Q000378:metabolism; D005638:Fruit / Q000009:adverse effects; D005919:Glomerular Filtration Rate; D006959:Hyperoxaluria / Q000188:drug therapy; D007668:Kidney / Q000503:physiopathology; D008297:Male; D010070:Oxalates / Q000009:adverse effects; D018384:Oxidative Stress / Q000187:drug effects*; D020011:Protective Agents / Q000494:pharmacology*; D051381:Rats; D017208:Rats, Wistar
chemical_list: D000975:Antioxidants; D010070:Oxalates; D020011:Protective Agents; D003404:Creatinine; D000111:Acetylcysteine
keywords: Acute kidney injury; N-acetylcysteine; acute oxalate nephropathy; oxidative stress; star fruit