Effect of N-acetylcysteine on Renal Functioning of Chronic Kidney Diseases(CKD) Patients After General Anesthesia
Status:
Unknown status
Trial end date:
2014-01-01
Target enrollment:
Participant gender:
Summary
Acute kidney injury (AKI) is one of the most serious and frequent complication of general
anesthesia. Patients suffer from chronic kidney diseases (CKD) predispose to develop AKI. CKD
patients often need some surgical interventions that have been done under general anesthesia;
they therefore have an increased probability to develop AKI.
N-acetylcysteine (NAC), a thiol compound with antioxidant and vasodilatory properties,
reduces oxygen free radical production, decreases pump-related ischemia-reperfusion injury
and the levels of pro-inflammatory cytokines. NAC has been reported to protect the kidney
from injury induced by contrast media, ischemia, and toxins.
Present study aimed to explore the efficacy of NAC treatment to prevent deterioration in
renal functioning in CKD patients undergoing major surgery under general anesthesia.
Study will include about 200 CKD (eGFR (estimated glomerular filtration rate) less than 40)
patients that should undergo surgical interventions under general anesthesia and will divide
to 3 groups as follows: group 1- about 40 patients which should undergo major vascular
surgery; group 2 - about 60 patients that suppose to undergo major orthopedic surgery
(revision of total hip, revision of knee); group 3 - about 100 patients undergoing major
abdominal surgery. Patients from each group will randomly divide in two sub-groups (A and B).
Subgroup A will receive NAC twice (14-16h and 2h) before surgery and 12h after surgery.
Subgroup B will receive placebo (saline).
Markers for kidney function such as eGFR, creatinin, urea, electrolytes, cystatin C, NGAL
(Neutrophil Gelatinase-Associated Lipocalin), urine albumin will measure before and after
surgery in all patients. An additional blood samples for assessment of nitric oxide and
cytokine levels will be taken from each patient before and after surgery.