Document Detail

Effect of oral N-acetylcysteine treatment on plasma inflammatory and oxidative stress markers in peritoneal dialysis patients: a placebo-controlled study.
MedLine Citation:
PMID:  20190028     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Inflammation and oxidative stress (OS) are cardiovascular risk factors in patients with chronic kidney disease. N-acetylcysteine (NAC) is a thiol-containing antioxidant with anti-inflammatory properties and has been shown to reduce the number of cardiovascular events in hemodialysis patients.
METHODS: The current study aimed to determine the effect of oral NAC (2 x 600 mg/daily) on plasma levels of inflammatory and OS markers in peritoneal dialysis (PD) patients. We performed a placebo-controlled study over 8 weeks in 30 patients (40% males, age 52 +/- 13 years) on regular PD. Before the study was started, the patients were divided into 2 groups of 15 patients matched for age and gender. 22 patients completed the study (12 on NAC, 10 on placebo). Proinflammatory cytokines [high-sensitivity C-reactive protein, interleukin-6 (IL-6), tumor necrosis factor-alpha, and pentraxin 3] and markers of OS (pentosidine, advanced oxidation protein products, homocysteine, glutathione, asymmetric dimethylarginine, and free sulfhydryls) were measured before and after treatment with NAC.
RESULTS: Treatment with NAC for 8 weeks increased mean baseline plasma NAC levels from 2.6 to 24.8 mumol/L (p = 0.007). This intervention, which caused no side effects, significantly diminished IL-6 levels, from 9.4 (4.5 - 31) to 7.6 (4.9 - 13.5) pg/mL (p = 0.006), whereas no such changes were observed in the placebo group. NAC treatment did not significantly affect the other inflammatory and OS markers.
CONCLUSION: Short-term oral NAC treatment resulted in reduction of circulating IL-6, suggesting that such treatment could be a useful strategy in blunting the inflammatory response in PD patients.
Marcelo M Nascimento; Mohamed E Suliman; Margarete Silva; Tiago Chinaglia; Josiane Marchioro; Shirley Y Hayashi; Miguel C Riella; Bengt Lindholm; Björn Anderstam
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-02-26
Journal Detail:
Title:  Peritoneal dialysis international : journal of the International Society for Peritoneal Dialysis     Volume:  30     ISSN:  1718-4304     ISO Abbreviation:  Perit Dial Int     Publication Date:    2010 May-Jun
Date Detail:
Created Date:  2010-04-28     Completed Date:  2011-09-29     Revised Date:  2012-08-08    
Medline Journal Info:
Nlm Unique ID:  8904033     Medline TA:  Perit Dial Int     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  336-42     Citation Subset:  IM    
Faculdade Evangélica de Medicina do Paraná-Brasil, Curitiba, Brazil.
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MeSH Terms
Acetylcysteine / administration & dosage*
Administration, Oral
Antioxidants / administration & dosage*
Biological Markers / blood
C-Reactive Protein / analysis
Cardiovascular Diseases
Inflammation / drug therapy*
Interleukin-6 / blood
Middle Aged
Oxidative Stress / drug effects*
Peritoneal Dialysis*
Risk Factors
Serum Amyloid P-Component / analysis
Tumor Necrosis Factor-alpha / blood
Reg. No./Substance:
0/Antioxidants; 0/Biological Markers; 0/Interleukin-6; 0/Serum Amyloid P-Component; 0/Tumor Necrosis Factor-alpha; 148591-49-5/PTX3 protein; 616-91-1/Acetylcysteine; 9007-41-4/C-Reactive Protein

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