eISSN: 1896-9151
ISSN: 1734-1922
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vol. 5

Clinical research
Effect of N-acetylcysteine on microalbuminuria in patients with acute respiratory distress syndrome

Atabak Najafi
Mojtaba Mojtahedzadeh
Ata Mahmoodpoor
Mostafa Aghamohammadi
Arezou Ahmadi
Sheida Nahreini
Marzieh Pazuki
Mohammad Reza Khajavi
Mohammad Abdollahi

Arch Med Sci 2009; 5, 3: 408-414
Online publish date: 2009/10/22
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Introduction: Acute respiratory distress syndrome (ARDS) is associated with enlarged permeability of respiratory capillaries resulting in interstitial edema and microalbuminuria. This study investigated the effect of early treatment with N-acetylcysteine (NAC) on microalbuminuria/creatinine ratio and clinical improvement in ARDS.
Material and methods: Twenty-three patients with ARDS were randomly entered into two groups of study including regular therapy and regular therapy plus NAC. NAC was started with 150 mg/kg on the first day followed by 50 mg/kg at the second day. Urine sample was tested for microalbuminuria on 4, 6, 12, 24, 36, and 48 h post baseline.
Results: No significant correlation was found between microalbumin/creatinine ratio (MACR) and acute physiology and chronic health evaluation (APACHE II) or PaO2/FiO2 ratio and blood pressure in each group. Non-survivors showed higher urine albumin creatinine ratio (ACR) and physiologic scores than survivors. The patients outcome who treated with NAC showed significant improvement comparing with controls.
Conclusions: NAC improves global hypoxemia in the patients with acute lung injury. Improvement of oxidant/antioxidant balance by NAC increases the survival of patients with ARDS who are under oxidative crisis. Although limitations of this study do not let us to reach a conclusive decision but the impact of microalbominuria as a predictive of survival in ARDS patients receiving NAC seems essential. Conducting larger clinical trials are recommended.

N-acetylcysteine, acute respiratory distress syndrome, microalbuminuria

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