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N-acetyl cysteine and acute kidney injury after cardiac surgery

Year 2015, Volume: 6 Issue: 2, 93 - 95, 12.09.2015

Abstract

Acute kidney injury (AKI) is a very common and important complication of cardiac surgery. It is associated with severe complications including mortality. Cardiac surgery may induce oxidative stress and inflammation and both of these processes may be associated with AKI. N-acetyl cysteine (NAC) is a mucolytic agent and it has antioxidant and anti-inflammatory properties. Although positive results have been obtained in animal studies, however; no significant beneficial effects of NAC on AKI have been found in randomized studies and meta-analyses. Currently available data do not support to recommend NAC for the prevention of AKI after cardiac surgery.

References

  • Adabag AS, Ishani A, Bloomfield HE, Ngo AK, Wilt TJ. Efficacy of N-acetylcysteine in preventing renal injury after heart surgery: a systematic review of randomized trials. Eur Heart J 2009; 30: 1910–1917.
  • Elahi MM, Flatman S, Matata BM. Tracing the origins of postoperative atrial fibrillation: the concept of oxidative stress-mediated myocardial injury phenomenon. Eur J Car- diovasc Prev Rehabil 2008; 15: 735-741.
  • Baliga R, Ueda N, Walker PD, Shah SV. Oxidant mecha- nisms in toxic acute renal failure. Am J Kidney Dis 1997; 29: 465–477.
  • Bellomo R, Auriemma S, Fabbri A, D’Onofrio A, Katz N, McCullough PA, Ricci Z, Shaw A, Ronco C. The patho- physiology of cardiac surgery-associated acute kidney injury (CSA-AKI). Int J Artif Organs 2008; 31: 166–178.
  • Naughton F., Wijeysundera D., Karkouti K., Tait G., B WS. N-acetylcysteine to reduce renal failure after cardiac sur- gery: a systematic review and meta-analysis. Can J Anesth 2008; 55: 827-835.
  • Nigwekar SU, Kandula P. N-acetylcysteine in cardiovas- cular surgeryassociated renal failure: a meta-analysis. Ann Thorac Surg 2009; 87: 139–147.
  • Ho KM, Morgan DJR. Meta-analysis of N-acetylcysteine to prevent acute renal failure after major surgery. Am J Kid- ney Dis 2009; 53: 33–40.
  • Wang G, Bainbridge D, Martin J, Cheng D. N-acetylcyste- ine in Cardiac Surgery: Do the Benefits Outweigh the Risks? A Meta-Analytic Reappraisal. J Cardiothorac Vasc Anesth 2011; 25: 268-75.
  • Baker WL, Anglade MW, Baker EL, White CM, Kluger J, Coleman CI. Use of N-acetylcysteine to reduce post-cardio- thoracic surgery complications: a metaanalysis. Eur J Cardio- thorac Surg 2009; 35: 521–527.
  • Park M, Coca SG, Nigwekar SU, Garg AX, Garwood S, Parikh CR. Prevention and Treatment of Acute Kidney Injury in Patients Undergoing Cardiac Surgery: A Systematic Re- view. Am J Nephrol 2010; 31: 408–418.
  • Perioperative N-acetylcysteine to prevent renal dysfunction in high-risk patients undergoing CABG surgery. JAMA 2005; 294: 342–350.
  • El-Hamamsy I, Stevens LM, Carrier M, Pellerin M, Bouchard D, Demers P, Cartier R, Page P, Perrault LP. Effect of intravenous N-acetylcysteine on outcomes after coronary artery bypass surgery: A randomized, double-blinded, place- bo-controlled clinical trial. J Thorac Cardiovasc Surg 2007; 133: 7–12.

N-asetil sistein ve Kardiyak cerrahi sonrası akut böbrek hasarı

Year 2015, Volume: 6 Issue: 2, 93 - 95, 12.09.2015

Abstract

Akut böbrek hasarı (ABH), kalp cerrahisinin önemli ve sık bir komplikasyonudur. Bu durum ciddi mortaliteyi de içeren ciddi komplikasyonlarla ilişkilidir. Kardiyak cerrahi, oksidatif stresi veya inflamasyonu veya her ikisini birden indükleyerek ABH'na sebep olabilmektedir. N-asetil sistein (NAS) antioksidan ve antiinflamatuvar özellikleri olan bir mukolitik ajandır. Hayvan çalışmalarında pozitif sonuçları gözlenmekle beraber randomize kontrollü çalışmalarda ve meta analizlerde NAS'nin, ABH'na anlamlı faydalı etkileri saptanmamıştır. Halihazırdaki veriler, kalp cerrahisi sonrası ABH'ndan korunmada NAS kullanımını desteklememektedir.

References

  • Adabag AS, Ishani A, Bloomfield HE, Ngo AK, Wilt TJ. Efficacy of N-acetylcysteine in preventing renal injury after heart surgery: a systematic review of randomized trials. Eur Heart J 2009; 30: 1910–1917.
  • Elahi MM, Flatman S, Matata BM. Tracing the origins of postoperative atrial fibrillation: the concept of oxidative stress-mediated myocardial injury phenomenon. Eur J Car- diovasc Prev Rehabil 2008; 15: 735-741.
  • Baliga R, Ueda N, Walker PD, Shah SV. Oxidant mecha- nisms in toxic acute renal failure. Am J Kidney Dis 1997; 29: 465–477.
  • Bellomo R, Auriemma S, Fabbri A, D’Onofrio A, Katz N, McCullough PA, Ricci Z, Shaw A, Ronco C. The patho- physiology of cardiac surgery-associated acute kidney injury (CSA-AKI). Int J Artif Organs 2008; 31: 166–178.
  • Naughton F., Wijeysundera D., Karkouti K., Tait G., B WS. N-acetylcysteine to reduce renal failure after cardiac sur- gery: a systematic review and meta-analysis. Can J Anesth 2008; 55: 827-835.
  • Nigwekar SU, Kandula P. N-acetylcysteine in cardiovas- cular surgeryassociated renal failure: a meta-analysis. Ann Thorac Surg 2009; 87: 139–147.
  • Ho KM, Morgan DJR. Meta-analysis of N-acetylcysteine to prevent acute renal failure after major surgery. Am J Kid- ney Dis 2009; 53: 33–40.
  • Wang G, Bainbridge D, Martin J, Cheng D. N-acetylcyste- ine in Cardiac Surgery: Do the Benefits Outweigh the Risks? A Meta-Analytic Reappraisal. J Cardiothorac Vasc Anesth 2011; 25: 268-75.
  • Baker WL, Anglade MW, Baker EL, White CM, Kluger J, Coleman CI. Use of N-acetylcysteine to reduce post-cardio- thoracic surgery complications: a metaanalysis. Eur J Cardio- thorac Surg 2009; 35: 521–527.
  • Park M, Coca SG, Nigwekar SU, Garg AX, Garwood S, Parikh CR. Prevention and Treatment of Acute Kidney Injury in Patients Undergoing Cardiac Surgery: A Systematic Re- view. Am J Nephrol 2010; 31: 408–418.
  • Perioperative N-acetylcysteine to prevent renal dysfunction in high-risk patients undergoing CABG surgery. JAMA 2005; 294: 342–350.
  • El-Hamamsy I, Stevens LM, Carrier M, Pellerin M, Bouchard D, Demers P, Cartier R, Page P, Perrault LP. Effect of intravenous N-acetylcysteine on outcomes after coronary artery bypass surgery: A randomized, double-blinded, place- bo-controlled clinical trial. J Thorac Cardiovasc Surg 2007; 133: 7–12.
There are 12 citations in total.

Details

Primary Language English
Journal Section Editöre Mektup
Authors

Mehmet Özaydın

İbrahim Ersoy

Hasan Baş

Akif Arslan This is me

Publication Date September 12, 2015
Submission Date March 31, 2015
Published in Issue Year 2015 Volume: 6 Issue: 2

Cite

Vancouver Özaydın M, Ersoy İ, Baş H, Arslan A. N-acetyl cysteine and acute kidney injury after cardiac surgery. Süleyman Demirel Üniversitesi Sağlık Bilimleri Dergisi. 2015;6(2):93-5.

SDÜ Sağlık Bilimleri Dergisi, makalenin gönderilmesi ve yayınlanması dahil olmak üzere hiçbir aşamada herhangi bir ücret talep etmemektedir. Dergimiz, bilimsel araştırmaları okuyucuya ücretsiz sunmanın bilginin küresel paylaşımını artıracağı ilkesini benimseyerek, içeriğine anında açık erişim sağlamaktadır.