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N-Acetylcysteine does not artifactually lower plasma creatinine concentration.

Author(s)
Haase, Michael
Haase-Fielitz, Anja
Ratnaike, Sujiva
Reade, Michael C
Bagshaw, Sean M
Morgera, Stanislao
Dragun, Duska
Bellomo, Rinaldo
Publication Date
2008-01-17
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 Jaffé method. (ClinicalTrials.gov, NCT00332631, NCT00334191).
Citation
Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association 2008; 23(5): 1581-7
Jornal Title
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
Link
Title
N-Acetylcysteine does not artifactually lower plasma creatinine concentration.
Type of document
Journal Article

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