Effects of N-Acetyl Cysteine on Oxidative Stress Biomarkers in End-stage Renal Disease

Background and Objective: Imbalance between the oxidants and antioxidants in biologic systems is called oxidative stress which is associated with wide range of diseases and malfunctions. Renal physiology, high blood flow and reabsorption mechanisms make kidneys susceptible organs to oxidative stress, especially in End-Stage Renal Disease (ESRD) patients; because of their decreased antioxidant capacity along with increased oxidant species. N-Acetyl cysteine (NAC) is a known synthetic antioxidant. Our aim of study was to investigate helpful antioxidant effects of NAC on oxidative stress biomarkers in ESRD patients.

Methods: This double-blind, randomized clinical trial was done on 130 ESRD patients undergoing hemodialysis. Effects of one month administration of 3 different doses of oral NAC (600, 1200 and 1800 mg/day) on oxidative stress biomarkers (Glutathione (GSH), Malondialdehyde (MDA), Catalase (CAT) and Superoxide Dismutase (SOD)) were assessed. Each group was divided into two sub-groups of drug and placebo, randomly.

Results: GSH concentrations increased significantly in all three groups (P<0.05). Decrease in MDA levels in doses of 600 mg/day and 1200 mg/day were significant (P<0.05). Significant decrease in activity of CAT was observed by 600 mg/day of NAC (P<0.05). Slight but not significant decrease in SOD activity levels were observed in these three groups (P>0.05).

Conclusion: Data demonstrate the protective effects of NAC in ESRD patients against oxidative stress. Also, according to the results, dose of 600 mg/day is preferred for this clinical application.