Background: Oxidative stress and systemic inflammation is increased in end-stage renal
disease (ESRD) patients. Due to the various effects of oxidative stress in ESRD patients,
different antioxidants have been evaluated.
Objectives: In this study, we evaluated the effect of oral N-acetylcysteine (NAC) as
an antioxidant on the serum high-sensitive C-reactive protein (hs-CRP) and plasma
hemoglobin levels in the ESRD patients who were under routine hemodialysis.
Patients and Methods: In this randomized placebo-controlled clinical trial, 51 ESRD patients
under routine hemodialysis were randomly assigned to receive NAC 1200 mg daily for 1
month (n=26) or placebo (n=25). Laboratory findings including hemoglobin, ferritin, hsCRP
were measured in patients before and after treatment.
Results: NAC group compared to placebo group had significantly higher ferritin levels
before treatment (p=0.02) and lower phosphorus levels after treatment (p=0.03).
Comparing the results before and after treatment in each group, a significant reduction
in hematocrit (p=0.002), ferritin (p=0.006), hs-CRP (p=0.02) and an increase in alkaline
phosphatase levels (p=0.005) in NAC group and significant reduction in calcium levels
(p<0.001) in placebo group was detected. No major side effects were seen.
Conclusions: One month treatment with oral NAC resulted in reduced levels of hematocrit,
ferritin and Hs-CRP, indicative of role of NAC in controlling inflammation in ESRD
patients under hemodialysis. However, NAC was not effective in treatment of anemia,
although the treatment duration was low.