Modarresi Atieh, Nafar Mohsen, Sahraei Zahra, Salamzadeh Jamshid, Chaibakhsh Samira, Ziaie Shadi, Parvin Mahmoud, Panahi Yunes, Einollahi Behzad
a Research Center for Rational Use of Drugs, Tehran University of Medical Sciences , Tehran , Iran.
b Urology and Nephrology Research Center, Shahid Labbafinejad Medical Center, Shahid Beheshti University of Medical Sciences , Tehran , Iran.
Biomarkers. 2018 Sep;23(6):589-596. doi: 10.1080/1354750X.2018.1468823. Epub 2018 May 4.
Acute kidney injury (AKI) is a common complication after kidney transplantation (KT), especially in recipients from deceased donors. Urinary neutrophil gelatinase-associated lipocalin (u-NGAL) is an early and sensitive marker of AKI after transplantation.
We assessed the renoprotective effect of N-acetylcysteine (NAC) on u-NGAL levels as an early prognostic marker of graft function immediately after transplantation.
A double-blind, randomized, placebo-controlled trial was conducted on 70 deceased-donor KT recipients ( www.irct.ir , trial registration number: IRCT2014090214693N4). Patients received 600 mg oral NAC or placebo twice daily from day 0 to 5 and urine samples were taken before, and on the first and fifth days after transplantation. U-NGAL and early graft function were compared between the two groups.
NAC significantly reduced u-NGAL levels compared to placebo (p value = 0.02), while improvement in early graft function with NAC did not reach statistical significance.
This study showed that NAC administration in deceased-donor KT recipients can reduce tubular kidney injury, evidenced by u-NGAL measurements. Improvement in early graft function needs a larger sample size to reach a statistical conclusion.
急性肾损伤（AKI）是肾移植（KT）后常见的并发症，尤其是在接受已故供体肾脏的受者中。尿中性粒细胞明胶酶相关脂质运载蛋白（u-NGAL）是移植后AKI的早期敏感标志物。
我们评估了N-乙酰半胱氨酸（NAC）对u-NGAL水平的肾脏保护作用，将其作为移植后立即评估移植物功能的早期预后标志物。
对70例已故供体KT受者进行了一项双盲、随机、安慰剂对照试验（www.irct.ir，试验注册号：IRCT2014090214693N4）。患者从第0天至第5天每天口服600mg NAC或安慰剂两次，并在移植前、移植后第1天和第5天采集尿液样本。比较两组的u-NGAL和早期移植物功能。
与安慰剂相比，NAC显著降低了u-NGAL水平（p值=0.02），而NAC对早期移植物功能的改善未达到统计学意义。
本研究表明，在已故供体KT受者中给予NAC可减少肾小管损伤，这通过u-NGAL测量得到证实。早期移植物功能的改善需要更大的样本量才能得出统计学结论。
