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Title: N-Acetylcysteine does not artifactually lower plasma creatinine concentration.
Austin Authors: Haase, Michael;Haase-Fielitz, Anja;Ratnaike, Sujiva;Reade, Michael C;Bagshaw, Sean M;Morgera, Stanislao;Dragun, Duska;Bellomo, Rinaldo 
Affiliation: Director of Intensive Care Research, Austin Hospital, University of Melbourne, 3084 Heidelberg, Victoria, Australia
Issue Date: 17-Jan-2008
Publication information: Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association 2008; 23(5): 1581-7
Abstract: All randomized controlled trials of N-acetylcysteine (NAC) in contrast media-induced nephropathy used creatinine as a marker of renal function. However, it has been suggested that NAC may lower plasma creatinine levels independent of any effects on glomerular filtration rate (GFR).At a tertiary hospital 110 cardiac surgical patients were randomly allocated to peri-operative infusion of NAC (300 mg/kg over 24 h, N = 30) or placebo (N = 80). We compared the plasma concentrations of creatinine, cystatin C and urea, the plasma creatinine/plasma cystatin C ratio and the estimated GFR at baseline and at 24 and 72 h after commencement of the infusion. We measured urinary creatinine concentration at 24 h.At baseline, the plasma creatinine/plasma cystatin C ratio did not differ between the NAC and placebo group (0.90 versus 0.92; P = 0.94). There was no significant difference in the plasma creatinine/plasma cystatin C ratio for the NAC and placebo group either during or after NAC infusion at 24 h (1.03 versus 1.00; P = 0.78) and 72 h (0.94 versus 0.89; P = 0.09). Those allocated to NAC showed no difference in urinary creatinine excretion when compared to placebo (P = 0.24).The results of our study do not demonstrate that NAC artifactually lowers creatinine measured using the JaffĂ© method. (, NCT00332631, NCT00334191).
Gov't Doc #: 18202091
DOI: 10.1093/ndt/gfm818
Type: Journal Article
Subjects: Acetylcysteine.administration & dosage.pharmacology
Cardiac Surgical Procedures
Contrast Media.adverse effects
Cystatin C
Double-Blind Method
Glomerular Filtration Rate.drug effects
Infusions, Intravenous
Intraoperative Care
Kidney Diseases.etiology.physiopathology.prevention & control
Middle Aged
Appears in Collections:Journal articles

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