The effect of n-acetylcysteine in prime solution on preventing renal failure during cardiopulmonary bypass surgery

Abstract

Background: Cardiopulmonary bypass (CPB) has many benefits in improving heart surgery; but this method may cause kidney damage and kidney failure in some patients. N-acetylcysteine (NAC) is an anti-inflammatory agent that has protective effects on kidney function. The aim of the present study was to evaluate the effects of NAC on prevention of renal failure following CPB. Methods: In this double-blind clinical trial study, 100 patients who were candidates for coronary artery bypass grafting (CABG) at Shahid Chamran hospital in Isfahan, Iran, aged 40-65 years with glomerular filtration rate (GFR) of greater than 60 and creatinine level of less than 1.5 mg/dl were selected. The intervention group received 1200 mg of NAC in Prime solution. NAC was not used in the control group. The two groups were compared in terms of GFR and mortality. Data on blood levels of urea, creatinine, urine output, and intensive care unit (ICU) stay were collected. Findings: Patients in the two groups had relatively similar conditions in terms of mean age, height, weight, aortic clamp time, and pump. No mortality was reported in any of the groups. There was no significant difference between the ICU stay and the amount of urea in the two groups of intervention and control (P > 0.050). There was a significant difference in the urine output of patients in both groups in the first 24 hours after CPB (P < 0.050); but in the second 24 hours, the difference was not significant. There was significant differences in creatinine and GFR levels of patients with diabetes mellitus in the intervention group with other patients (P < 0.050). No patient death was reported in any of the statistical population groups. Conclusion: The results show that the use of NAC reduces creatinine and increases GFR in patients with diabetes mellitus, which indicates that the use of NAC may prevent renal failure in these patients. © 2021 Isfahan University of Medical Sciences(IUMS). All rights reserved.