Feldman Leonid, Abu Hamad Ramzia, Efrati Shai, Ashker Ali, Beberashvili Ilia, Shani Michal
Nephrology Division and Research & Development Unit, Assaf Harofeh Medical Center, Zerifin 70300, Israel ; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel.
Nephrology Division and Research & Development Unit, Assaf Harofeh Medical Center, Zerifin 70300, Israel.
ISRN Nephrol. 2012 Nov 26;2013:636208. doi: 10.5402/2013/636208. eCollection 2013.
Background. Preservation of residual renal function in chronic dialysis patients has proven to be a major predictor of survival. The aim of the present study was to investigate an ability of the combined use of N-acetylcysteine and high-flux biocompatible haemodialysis membranes to improve residual renal function in haemodialysis patients. Patients and Methods. Chronic haemodialysis patients with a residual urine output of at least 100 mL/24 h were administered oral an N-acetylcysteine 1200 mg twice daily for 2 weeks. Treatment group included patients treated with dialysers using high-flux synthetic biocompatible membranes. Control group included patients treated with dialysers using low-flux semisyntetic triacetate haemodialysis membranes. Results. Eighteen patients participated in the study. The residual glomerular filtration rate showed a nonsignificant trend for increase in both groups. The magnitude of GFR improvement after N-acetylcysteine administration was less pronounced in the group treated with high-flux biocompatible membranes: +0.17 ± 0.56 mL/min/1.73 m(2) in treatment group and +0.65 ± 0.53 mL/min/1.73 m(2) in control group (P < 0.05). Conclusion. In this study of favorable effect of N-acetylcysteine on residual renal function in chronic haemodialysis patients may be less pronounced when using high-flux biocompatible, rather than low-flux semisyntetic, HD membranes.
背景。在慢性透析患者中，保留残余肾功能已被证明是生存的主要预测指标。本研究的目的是探讨联合使用N-乙酰半胱氨酸和高通量生物相容性血液透析膜改善血液透析患者残余肾功能的能力。
患者与方法。残余尿量至少为100 mL/24 h的慢性血液透析患者口服N-乙酰半胱氨酸1200 mg，每日两次，共2周。治疗组包括使用高通量合成生物相容性膜透析器治疗的患者。对照组包括使用低通量半合成三醋酸血液透析膜透析器治疗的患者。
结果。18名患者参与了研究。两组患者的残余肾小球滤过率均呈非显著性升高趋势。在使用高通量生物相容性膜治疗的组中，服用N-乙酰半胱氨酸后肾小球滤过率改善的幅度较小：治疗组为+0.17±0.56 mL/min/1.73 m²，对照组为+0.65±0.53 mL/min/1.73 m²（P<0.05）。
结论。在本研究中，对于慢性血液透析患者，使用高通量生物相容性而非低通量半合成血液透析膜时，N-乙酰半胱氨酸对残余肾功能的有益作用可能不太明显。
