Nephrology Division, Assaf Harofeh Medical Center, Zerifin, Israel.
Perit Dial Int. 2011 Sep-Oct;31(5):545-50. doi: 10.3747/pdi.2009.00263. Epub 2010 Aug 12.
Preservation of peritoneal membrane function and residual renal function is important for the optimal care of peritoneal dialysis patients. N-Acetylcysteine may ameliorate oxidative stress, which is thought to be involved in peritoneal membrane dysfunction. In addition, N-acetylcysteine may have a positive effect on renal function in the setting of nephrotoxic contrast media administration. The aim of this study was to investigate the effect of N-acetylcysteine on peritoneal and residual renal function in peritoneal dialysis patients.
Ten prevalent peritoneal dialysis patients were administered oral N-acetylcysteine 1200 mg twice daily for 4 weeks. At baseline and at the end of treatment, peritoneal membrane function and residual renal function were assessed using a 4.25% dextrose peritoneal equilibration test and 24-hour dialysate and urine collection for calculation of peritoneal and residual renal Kt/V and mean urea and creatinine residual renal clearance.
No significant changes were demonstrated in peritoneal membrane function, including dialysate-to-plasma creatinine ratio, sodium sieving, and net ultrafiltration. Residual renal function improved significantly: urine volume increased from 633 ± 426 to 925 ± 552 mL/24 hours (p = 0.022), residual renal Kt/V increased from 0.56 ± 0.41 to 0.75 ± 0.47 (p = 0.037), and mean residual urea and creatinine clearance increased from 4.96 ± 3.96 to 5.95 ± 4.08 mL/min/1.73 m(2) (p = 0.059).
N-acetylcysteine may improve residual renal function in patients treated with peritoneal dialysis.
保留腹膜功能和残余肾功能对于腹膜透析患者的最佳治疗非常重要。N-乙酰半胱氨酸可以改善氧化应激，氧化应激被认为与腹膜功能障碍有关。此外，N-乙酰半胱氨酸在使用肾毒性造影剂时可能对肾功能有积极影响。本研究旨在探讨 N-乙酰半胱氨酸对腹膜透析患者腹膜和残余肾功能的影响。
10 例持续性腹膜透析患者每天口服 N-乙酰半胱氨酸 1200mg，分两次服用，共 4 周。在基线和治疗结束时，使用 4.25%葡萄糖腹膜平衡试验以及 24 小时透析液和尿液收集来评估腹膜和残余肾功能，计算腹膜和残余肾 Kt/V 以及平均尿素和肌酐残余肾清除率。
腹膜功能没有明显变化，包括透析液与血浆肌酐比值、钠筛系数和净超滤量。残余肾功能显著改善：尿量从 633 ± 426 增加到 925 ± 552 mL/24 小时（p = 0.022），残余肾 Kt/V 从 0.56 ± 0.41 增加到 0.75 ± 0.47（p = 0.037），平均残余尿素和肌酐清除率从 4.96 ± 3.96 增加到 5.95 ± 4.08 mL/min/1.73 m(2)（p = 0.059）。
N-乙酰半胱氨酸可能改善腹膜透析患者的残余肾功能。
