Comparison of Outcomes Between High and Standard Dose of N-acetylcysteine in Prevention of AKI in Patients with CKD

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dc.contributor.authorAkhter, Mahbubaen_US
dc.contributor.authorWaheed, Shahryaren_US
dc.contributor.authorRahman, Mohammad Syfuren_US
dc.contributor.authorHossain, MD. Sorowaren_US
dc.contributor.authorDewan, Shah Newazen_US
dc.contributor.authorSaha, Nirupamaen_US
dc.contributor.authorIqbal, Masuden_US
dc.date.accessioned2023-07-21T11:26:09Z
dc.date.available2023-07-21T11:26:09Z
dc.date.issued2022-12
dc.description.abstractBackground: Patients with chronic kidney disease (CKD) are at a common risk for contrast-induced acute kidney damage (CI-AKI) because of various complications. Intravenous N-acetylcysteine (NAC) in high doses (1200mg) is considered more effective than its conventional dose (600mg) to prevent CIN and related complications. Objective: The study aimed to compare the effectiveness of high dose versus standard dose of intravenous N-acetylcysteine (NAC) in the prevention of Acute Kidney Injury in patients with chronic kidney disease.Material & Methods:A total of 60 (sixty) patients diagnosed with CKD went to coronary angiography and/or percutaneous coronary intervention (PCI) were selected by simple random technique and categorized into two groups – Group A (30 patients) received high dose NAC (1200mg) and Group B (30 patients) – received standard dose NAC (600mg). For evaluation of renal damage serum creatinine level for at least >3 months, renal imaging revealed bilateral small echogenic kidneys, eGFR (<60 to 15ml/min/1.73m², measured by MDRD formula) and also by ACR >30 mg/gm, associated with IHD, admitted for percutaneous intervention (PCI) were taken in account. Statistical analysis was done by SPSS version 20 with taking 95% confidence interval. The quantitative data were expressed as mean and standard deviation and qualitative data were expressed as frequency distribution and unpaired t-test, Chi-square test, and Fisher exact analytic test were done.Results:The observed mean age group of the patients was 65 ± 8 years and 62 ± 7 years in group A and group B respectively with male predominance in both groups. Primary renal disease diabetic nephropathy (DN) more (36.66%) in group A than in group B (30.00%) but patients with Hypertensive nephropathy were the same (33.33%) in both groups. After interventions, S. Creatinine (mg/dl) level, e, GFR (ml/min/1.73m²), were statistically significant in cases of group A patients (P-value 0.001& 0.003 correspondingly) compared to group B Patients (P-value 0.075 & 0.001 respectively). Again, the mean of pre-intervention S. Creatinine was 1.7 ±0.5 in group A whereas this was 1.9 ± 0.8 (p-value, 0.599) in group B and after 48 hours of intervention this was 1.6 ± 0.5 and 2.0 ± 0.5 (p-value, 0.697) In group A and group B respectively. Overall, no patients were detected with nephropathy for high dose NAC whereas 27 (90%) out of 30 had developed CIN in standered dose.Conclusion:High-dose N-acetylcysteine (1200mg) is more potent and effective than the standard dose (600mg) in reducing contrast-induced acute kidney injury (CI-AKI) in patients with CKD.en_US
dc.identifier.affiliationsAssociate Professor, Department of Nephrology, Ashiyan Medical College Hospital, Dhaka. Email: mahbuba444@gmail.com Orcid ID: 0000-0003-0854-8452en_US
dc.identifier.affiliationsAssociate Professor, Department of Nephrology, Sir Salimullah Medical College Hospital, Dhaka. Email: wshahryar@gmail.com Orcid ID: 0000-0002-8255-049Xen_US
dc.identifier.affiliationsAssistant Professor, Department of Nephrology, Sylhet MAG Osmani Medical College Hospital, Sylhet. Email: syfur27@gmail.com Orcid ID: 0000-0003-3072-4395en_US
dc.identifier.affiliationsDialysis Medical Officer, National Institute of Kidney Diseases and Urology. Dhaka. Email: ripon.sbmc.23@gmail.com Orcid ID: 0000-0003-2872-0782en_US
dc.identifier.affiliationsJunior Consultant Department of Nephrology, Kurmitola Genenral Hospital, Dhaka. Email: dewanshahnewaz@gmail.com Orcid ID: 0000-0002-9707-1168en_US
dc.identifier.affiliationsAssistant Professor, Department of Pediatric Surgery, Shaheed Suhrawardy Medical College, Dhaka, Bangladesh. Email: nirupamasaha@ yahoo.com Orcid ID: 0000-0003-3486677Xen_US
dc.identifier.affiliationsProfessor (Ex-Director), National Institute of Kidney Diseases and Urology. Dhaka. Email: masud_ 1232001@ yahoo.com Orcid ID: 0000-0003-3725-1068en_US
dc.identifier.citationAkhter Mahbuba, Waheed Shahryar, Rahman Mohammad Syfur, Hossain MD. Sorowar, Dewan Shah Newaz, Saha Nirupama, Iqbal Masud. Comparison of Outcomes Between High and Standard Dose of N-acetylcysteine in Prevention of AKI in Patients with CKD. Annals of International Medical and Dental Research. 2022 Dec; 8(6): 70-77en_US
dc.identifier.issn2395-2822
dc.identifier.issn2395-2814
dc.identifier.placeIndiaen_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/220070
dc.languageenen_US
dc.publisherScholars Publisheren_US
dc.relation.issuenumber6en_US
dc.relation.volume8en_US
dc.source.urihttps://doi.org/10.53339/aimdr.2022.8.6.10en_US
dc.subjectN-acetylcysteineen_US
dc.subjectAKIen_US
dc.subjectCKDen_US
dc.titleComparison of Outcomes Between High and Standard Dose of N-acetylcysteine in Prevention of AKI in Patients with CKDen_US
dc.typeJournal Articleen_US
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