Dialysis Unit, General Hospital of Serres, 62120, Serres, Greece.
Division of Nephrology and Hypertension, 1st Department of Internal Medicine, School of Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, 54636, Thessaloniki, Greece.
Int Urol Nephrol. 2023 Jun;55(6):1481-1492. doi: 10.1007/s11255-022-03455-3. Epub 2023 Jan 3.
Oxidative stress (OS) has been recognized as a pathophysiologic mechanism underlying the development and progression of chronic kidney disease (CKD). OS, which results from the disturbance of balance among pro-oxidants and antioxidants favoring the pro-oxidants, is present even in early CKD and increases progressively along with deterioration of kidney function to end-stage kidney disease (ESKD). In ESKD, OS is further exacerbated mainly due to dialysis procedures per se and predisposes to increased cardiovascular morbidity and mortality. Therefore, since OS plays a pivotal role in the pathogenesis and progression of atherosclerosis in uremic patients, several strategies aiming to ameliorate OS in these patients have been proposed. Among those, N-acetylcysteine (NAC), a thiol-containing antioxidant agent, has attracted special attention due to its pleiotropic functions and beneficial effect in various OS-related entities including paracetamol overdose and prevention of contrast-induced nephropathy. In this review, we present the currently available literature on the antioxidant and anti-inflammatory properties of NAC in CKD, including hemodialysis and peritoneal dialysis.
氧化应激（OS）已被认为是慢性肾脏病（CKD）发展和进展的病理生理机制。OS 是由于促氧化剂和抗氧化剂之间的平衡失调而导致的，即使在早期 CKD 中也存在，并且随着肾功能的恶化，其程度逐渐加重，直至终末期肾病（ESKD）。在 ESKD 中，OS 主要由于透析本身而进一步加剧，并导致心血管发病率和死亡率增加。因此，由于 OS 在尿毒症患者动脉粥样硬化的发病机制和进展中起着关键作用，因此提出了几种旨在改善这些患者 OS 的策略。其中，N-乙酰半胱氨酸（NAC）作为一种含巯基的抗氧化剂，由于其多种功能和在包括对乙酰氨基酚过量和预防造影剂肾病在内的各种与 OS 相关实体中的有益作用而受到特别关注。在这篇综述中，我们介绍了目前关于 NAC 在 CKD 中的抗氧化和抗炎特性的文献，包括血液透析和腹膜透析。
