THE ROLE OF INTRAVENOUS N-ACETYLCYSTEINE REDUCES PULSE PRESSURE IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 5 DURING HEMODIALYSIS: A RANDOMIZED BLINDED TRIAL
ABSTRACT: Patients with
chronic kidney disease have increased oxidative stress that cause endothelial
dysfunction and show elevated pulse pressure. Whether increased pulse pressure
can be prevented by the administration of antioxidants is unknown. Methods and Results – We evaluated the effect
of N-acetylcysteine, a thiol-containing antioxidant, on pulse pressure in
patients undergoing hemodialysis. A randomized, blinded trial was done in 60
patients (39 male and 21 female) with a mean age of 48.10 + 11.08 years in N-acetylcysteine
group and 52.60 + 10.30 years in control
group (p=0.338). They had been undergoing reguler hemodialysis for 4 hours 2
times weekly in Hemodialysis Unit Dr. Soetomo Teaching Hospital, Surabaya.
Patients were randomly assigned either to receive intravenous N-acetylcysteine
(Hidonac 5 gram/25 ml solution) or placebo. The primary end point was a
composite variable consisting of pulse pressure. A total of 30 (50%) of the 60
hemodialysis patients assigned to N-acetylcysteine group and 30 (50%) of the
remaining patients assigned to control group. The significant differences in
pulse pressure were detected before and after the intravenous N-acetylcysteine
and also than control group.
Conclusions: In hemodialysis patients, treatment with N-acetylcysteine
(Hidonac 5 gram/25 ml solution) reduces pulse pressure.
Author: Mohammad Yogiantoro
Journal Code: jpkedokterangg050050
