Early Graft Function in Deceased Donor Renal Recipients: Role of N-Acetylcysteine

AuthorAtieh Modarresien
AuthorMohsen Nafaren
AuthorZahra Sahraeien
AuthorJamshid Salamzadehen
AuthorShadi Ziaieen
Issued Date2020-01-31en
AbstractReduced graft function (RGF) in donor renal transplant recipients is caused by oxidative damage due to extensive ischemia-reperfusion (I/R) injury during transplantation. Neutrophil gelatinase-associated lipocalin (NGAL) is a promising biomarker to detect tubular injury early after renal transplantation. N-acetylcysteine (NAC) is a potent antioxidant that can reduce I/R injury by improving oxidative damage. The aim of the present study is to assess the efficacy of NAC in improving graft function and reducing renal tubular injury in deceased donor renal transplant recipients. A double-blind, randomized clinical trial was conducted on 50 deceased donor renal transplant recipients. The patients were randomized into two groups, receiving either 600 mg NAC twice daily, or placebo (days 0 to 5). Results were assessed based on the rate of RGF, levels of plasma NGAL (p-NGAL) and the estimated glomerular filtration rate (eGFR). The rate of RGF was significantly lower in the patients receiving NAC vs. placebo (21.4% vs. 50%). The measurement of p-NGAL levels showed that the patients in the NAC group had significantly greater reduction of p-NGAL by both days 1 and 5 post-transplantation than those in the placebo group. A near steady-state eGFR level was reached by week 1 in the NAC group, however, the improvement of eGFR was significantly slower in the placebo group and a near steady-state was only achieved by week 4. NAC has promising potential in reducing tubular injury and improving graft function, evidenced by significant reduction in the rate of RGF and levels of p-NGAL.en
DOIhttps://doi.org/10.22037/ijpr.2019.15546.13167en
KeywordTransplantsen
KeywordKidney Transplantationen
KeywordReperfusion Injuryen
KeywordAcetylcysteineen
KeywordLipocalin-2en
KeywordGlomerular Filtration Rateen
PublisherBrieflandsen
TitleEarly Graft Function in Deceased Donor Renal Recipients: Role of N-Acetylcysteineen
TypeOriginal Articleen

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