Saddadi Fereshteh, Alatab Sudabeh, Pasha Farahnaz, Ganji Mohammad Reza, Soleimanian Tayebeh
Nephrology Department, Dr. Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Saudi J Kidney Dis Transpl. 2014 Jan;25(1):66-72. doi: 10.4103/1319-2442.124489.
Patients with end-stage renal disease (ESRD) are at an increased risk of cardiovascular disease due to many factors including inflammation and oxidative stress. N-acetylcysteine (NAC) is a thiol-containing anti-oxidant with anti-inflammatory properties. We aimed to assess the effect of three months treatment with oral NAC on the plasma levels of inflammatory mediators like interleukin-6 (IL-6) and C-reactive protein (hs-CRP) in patients on hemodialysis (HD). Twenty-four patients (nine males and 15 females) on maintenance HD were recruited in the study. Their mean age was 55.3 years. All the patients received oral NAC (600 mg twice a day) for a period of three months. The serum levels of biomedical parameters and IL-6 and hs-CRP were measured at baseline and three months after initiation of treatment. A significant decrease in serum levels of hs-CRP (22.4 vs. 5.2), IL-6 (8.1 vs. 3.6), parathyroid hormone (iPTH) (257.2 vs. 158.8), ferritin (632.0 vs. 515.1) and erythrocyte sedimentation rate (ESR) (54.2 vs. 38.3) was observed following NAC treatment. Female subjects presented with a significantly higher change in serum levels of hs-CRP compared with males (23 vs. 5.4). In three subjects who were less than 40 years old, the hs-CRP and IL-6 levels showed an increase following NAC treatment. Our study found that short-term oral NAC treatment might result in the reduction of IL-6 and hs-CRP in patients who are on regular HD. This suggests that patients with ESRD may benefit from the anti-inflammatory effects of NAC.
终末期肾病（ESRD）患者由于包括炎症和氧化应激在内的多种因素，患心血管疾病的风险增加。N-乙酰半胱氨酸（NAC）是一种含硫醇的抗氧化剂，具有抗炎特性。我们旨在评估口服NAC三个月治疗对血液透析（HD）患者血浆中白细胞介素-6（IL-6）和高敏C反应蛋白（hs-CRP）等炎症介质水平的影响。本研究招募了24例维持性HD患者（9例男性和15例女性）。他们的平均年龄为55.3岁。所有患者接受口服NAC（每日两次，每次600 mg），为期三个月。在基线和治疗开始三个月后测量生物医学参数以及IL-6和hs-CRP的血清水平。NAC治疗后，hs-CRP（22.4对5.2）、IL-6（8.1对3.6）、甲状旁腺激素（iPTH）（257.2对158.8）、铁蛋白（632.0对515.1）和红细胞沉降率（ESR）（54.2对38.3）的血清水平显著降低。女性受试者hs-CRP血清水平的变化明显高于男性（23对5.4）。在3名年龄小于40岁的受试者中，NAC治疗后hs-CRP和IL-6水平升高。我们的研究发现，短期口服NAC治疗可能会使规律HD患者的IL-6和hs-CRP降低。这表明ESRD患者可能受益于NAC的抗炎作用。
