Effect of oral N-acetylcysteine treatment on plasma inflammatory and oxidative stress markers in peritoneal dialysis patients: A placebo-controlled study

Nascimento M.M.; Suliman M.E.; Silva M.; Chinaglia T.; Marchioro J.; Hayashi S.Y.; Riella M.C.; Lindholm B.; Anderstam B.

Effect of oral N-acetylcysteine treatment on plasma inflammatory and oxidative stress markers in peritoneal dialysis patients: A placebo-controlled study

Tipo

Artigo

Data de publicação

2010

Periódico

Peritoneal Dialysis International

Citações (Scopus)

94

Autores

Nascimento M.M.
Suliman M.E.
Silva M.
Chinaglia T.
Marchioro J.
Hayashi S.Y.
Riella M.C.
Lindholm B.
Anderstam B.

Resumo

Background: Inflammation and oxidative stress (OS) are cardiovascular risk factors in patients with chronic kidney disease. N-acetylcysteine (NAC) is a thiol-containing antioxidant with anti-inflammatory properties and has been shown to reduce the number of cardiovascular events in hemodialysis patients. Methods: The current study aimed to determine the effect of oral NAC (2 × 600 mg/daily) on plasma levels of inflammatory and OS markers in peritoneal dialysis (PD) patients. We performed a placebo-controlled study over 8 weeks in 30 patients (40% males, age 52 ± 13 years) on regular PD. Before the study was started, the patients were divided into 2 groups of 15 patients matched for age and gender. 22 patients completed the study (12 on NAC, 10 on placebo). Proinflammatory cytokines [high-sensitivity C-reactive protein, interleukin-6 (IL-6), tumor necrosis factor-alpha, and pentraxin 3] and markers of OS (pentosidine, advanced oxidation protein products, homocysteine, glutathione, asymmetric dimethylarginine, and free sulfhydryls) were measured before and after treatment with NAC. Results: Treatment with NAC for 8 weeks increased mean baseline plasma NAC levels from 2.6 to 24.8 μμmol/L (p = 0.007). This intervention, which caused no side effects, significantly diminished IL-6 levels, from 9.4 (4.5 - 31) to 7.6 (4.9 - 13.5) pg/mL (p = 0.006), whereas no such changes were observed in the placebo group. NAC treatment did not significantly affect the other inflammatory and OS markers. Conclusion: Short-term oral NAC treatment resulted in reduction of circulating IL-6, suggesting that such treatment could be a useful strategy in blunting the inflammatory response in PD patients. © 2010 International Society for Peritoneal Dialysis.