N-ACETYLCYSTEINE IMPROVES RESIDUAL RENAL FUNCTION IN PERITONEAL DIALYSIS PATIENTS: A PILOT STUDY
N-ACETYLCYSTEINE IMPROVES RESIDUAL RENAL FUNCTION IN PERITONEAL DIALYSIS PATIENTS: A PILOT STUDY
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DOI：
10.3747/pdi.2009.00263
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发表时间：
2011-09-01
影响因子：
2.8
通讯作者：
Weissgarten, Joshua
中科院分区：
文献类型：
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作者：
Feldman, Leonid;Shani, Michal;Weissgarten, Joshua
背景：腹膜功能和残余肾功能的保存对腹膜透析患者的最佳护理至关重要。n -乙酰半胱氨酸可能改善氧化应激，氧化应激被认为与腹膜功能障碍有关。此外，n -乙酰半胱氨酸在肾毒性造影剂的使用中可能对肾功能有积极作用。本研究旨在探讨n -乙酰半胱氨酸对腹膜透析患者腹膜及残余肾功能的影响。方法：10例腹膜透析患者口服n -乙酰半胱氨酸1200 mg，每日2次，连续4周。在基线和治疗结束时，采用4.25%葡萄糖腹膜平衡试验和24小时透析和尿液收集来评估腹膜功能和残余肾功能，计算腹膜和残余肾Kt/V以及平均尿素和肌酐残余肾清除率。结果：透析液-血浆肌酐比、钠筛分、净超滤等腹膜功能未见明显变化。残余肾功能明显改善：尿量从633 +/- 426增加到925 +/- 552 mL/24 h (p = 0.022)，肾脏残余Kt/V从0.56 +/- 0.41增加到0.75 +/- 0.47 (p = 0.037)，平均残余尿素和肌酐清除率从4.96 +/- 3.96增加到5.95 +/- 4.08 mL/min/1.73 m（p = 0.059）。结论：n -乙酰半胱氨酸可改善腹膜透析患者的残余肾功能。
Background: Preservation of peritoneal membrane function and residual renal function is important for the optimal care of peritoneal dialysis patients. N-Acetylcysteine may ameliorate oxidative stress, which is thought to be involved in peritoneal membrane dysfunction. In addition, N-acetylcysteine may have a positive effect on renal function in the setting of nephrotoxic contrast media administration. The aim of this study was to investigate the effect of N-acetylcysteine on peritoneal and residual renal function in peritoneal dialysis patients.Methods: Ten prevalent peritoneal dialysis patients were administered oral N-acetylcysteine 1200 mg twice daily for 4 weeks. At baseline and at the end of treatment, peritoneal membrane function and residual renal function were assessed using a 4.25% dextrose peritoneal equilibration test and 24-hour dialysate and urine collection for calculation of peritoneal and residual renal Kt/V and mean urea and creatinine residual renal clearance.Results: No significant changes were demonstrated in peritoneal membrane function, including dialysate-toplasma creatinine ratio, sodium sieving, and net ultrafiltration. Residual renal function improved significantly: urine volume increased from 633 +/- 426 to 925 +/- 552 mL/24 hours (p = 0.022), residual renal Kt/V increased from 0.56 +/- 0.41 to 0.75 +/- 0.47 (p = 0.037), and mean residual urea and creatinine clearance increased from 4.96 +/- 3.96 to 5.95 +/- 4.08 mL/min/1.73 m(2) (p = 0.059).Conclusions: N-acetylcysteine may improve residual renal function in patients treated with peritoneal dialysis.