ISSN: 2251-8363    eISSN: 2251-8819  
J Nephropathol. 2018;7(4):268-272.
doi:10.15171/jnp.2018.53

Original Article

The effect of oral N-acetylcysteine on serum high sensitive CRP and plasma hemoglobin levels in end-stage renal disease patients under routine hemodialysis; a randomized placebocontrolled clinical trial

Bahman Bashardoust 1, Roya Alaei 1 * , Sousan Mohammadi Kebar 1, Sabah Hasani 2, Afshin Habibzadeh 1

1 Department of Internal Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
2 Department of Internal Medicine, Kurdestan University of Medical Sciences, Sanandaj, Iran
*Corresponding author: Roya Alaee, E-mail: r Email: oyaalaei@icloud.com

Abstract

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.

Implication for health policy/practice/research/medical education:

Oxidative stress and systemic inflammation is increased in end-stage renal disease patients. Treatment with oral N-acetylcysteine 1200 mg daily could reduce levels of hematocrit, ferritin and Hs-CRP, indicative of role of N-acetylcysteine in controlling inflammation in end-stage renal disease patients under hemodialysis.

Please cite this paper as: Bashardoust B, Alaei R, Mohammadi Kebar S, Hasani S, Habibzadeh A. The effect of oral N-acetylcysteine on serum high sensitive CRP and plasma hemoglobin levels in end-stage renal disease patients under routine hemodialysis; a randomized placebo-controlled clinical trial. J Nephropathol. 2018;7(4):268-272. DOI: 10.15171/jnp.2018.53. 

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Submitted: 03 Jun 2017

Accepted: 18 Aug 2017
First published online: 02 Sep 2017
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