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Effects of N-acetyl cysteine on renal functions evaluated by blood neutrophil gelatinase-associated lipocalin levels in geriatric patients undergoing coronary artery bypass grafting [Anatol J Cardiol]
Anatol J Cardiol. 2016; 16(7): 504-511 | DOI: 10.5152/AnatolJCardiol.2015.6287  

Effects of N-acetyl cysteine on renal functions evaluated by blood neutrophil gelatinase-associated lipocalin levels in geriatric patients undergoing coronary artery bypass grafting

Mustafa Aldemir1, Halit Buğra Koca2, Elif Doğan Baki3, Görkem Çarşanba1, Nilgün Öztürk Kavrut4, Ali Sait Kavaklı4, Fahri Adalı1, Mustafa Emmiler5, Osman Tansel Darçın1
1Departments Of Cardiovascular Surgery, Faculty Of Medicine, Kocatepe University, Afyonkarahisar- Turkey
2Clinical Biochemistry, Faculty Of Medicine, Kocatepe University, Afyonkarahisar- Turkey
3Anesthesiology And Reanimation, Faculty Of Medicine, Kocatepe University, Afyonkarahisar- Turkey
4Departments Of Anesthesiology And Reanimation, Antalya Education And Research Hospital, Antalya- Turkey
5Cardiovascular Surgery, Antalya Education And Research Hospital, Antalya- Turkey

Objective: Recent conflicting studies on the renal effects of N-acetyl cysteine (NAC) after cardiac surgery have been published. The aim of this study was to evaluate the renal effects of NAC using neutrophil gelatinase-associated lipocalin (NGAL) blood levels in elderly patients undergoing coronary artery bypass grafting (CABG).
Methods: This randomized, double-blinded, placebo-controlled study was conducted among geriatric patients (>65 years) scheduled to undergo CABG. A total of 60 consecutive patients were randomly assigned to 2 groups. The first group received I.V. NAC (n=30) and the second group received placebo (n=30) at induction of anesthesia and then for 20 h. NGAL values were determined and conventional renal function tests were performed. Statistical analysis was performed using SPSS 17.0 (IL, Chicago, USA). A p value of <0.05 was considered statistically significant
Results: Plasma creatinine levels at 24 h postoperatively were significantly higher in the placebo group than in the NAC group (1.41±0.63 vs. 1.13±0.35; p<0.05). The mean serum NGAL levels at 3 h postoperatively were higher in the placebo group than in the NAC group (104.94±30.51 vs. 87.82±25.18; p<0.05). NGAL levels were similar between the groups at all other measurement time points. Plasma creatinine levels of ≥1.5 mg/dL or >25% of the baseline value at any time during the study period were observed in 27% of patients in the NAC group and 37% of patients in the placebo group; the difference was statistically significant (p<0.05).
Conclusion: In the present study, we found that I.V. NAC infusion in elderly patients undergoing CABG reduced the incidence of acute kidney injury as determined by blood NGAL and creatinine levels. (Anatol J Cardiol 2016; 16: 504-11)

Keywords: geriatric, coronary artery surgery, NAC, NGAL, kidney injury


Mustafa Aldemir, Halit Buğra Koca, Elif Doğan Baki, Görkem Çarşanba, Nilgün Öztürk Kavrut, Ali Sait Kavaklı, Fahri Adalı, Mustafa Emmiler, Osman Tansel Darçın. Effects of N-acetyl cysteine on renal functions evaluated by blood neutrophil gelatinase-associated lipocalin levels in geriatric patients undergoing coronary artery bypass grafting. Anatol J Cardiol. 2016; 16(7): 504-511

Corresponding Author: Mustafa Aldemir, Türkiye


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