N-acetylcysteine does not artifactually lower plasma creatinine concentration

Haase, Michael, Haase-Fielitz, Anja, Ratnaike, Sujiva, Reade, Michael C., Bagshaw, Sean M., Morgera, Stanislao, Dragun, Duska and Bellomo, Rinaldo (2008) N-acetylcysteine does not artifactually lower plasma creatinine concentration. Nephrology Dialysis Transplantation, 23 5: 1581-1587. doi:10.1093/ndt/gfm818

Author Haase, Michael
Haase-Fielitz, Anja
Ratnaike, Sujiva
Reade, Michael C.
Bagshaw, Sean M.
Morgera, Stanislao
Dragun, Duska
Bellomo, Rinaldo
Title N-acetylcysteine does not artifactually lower plasma creatinine concentration
Journal name Nephrology Dialysis Transplantation   Check publisher's open access policy
ISSN 0931-0509
Publication date 2008-05
Sub-type Article (original research)
DOI 10.1093/ndt/gfm818
Open Access Status Not yet assessed
Volume 23
Issue 5
Start page 1581
End page 1587
Total pages 7
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Background: All randomized controlled trials of N-acetylcysteine (NAC) in contrast media-induced nephropathy used creatinine as a marker of renal function. However, it has been suggested that NAC may lower plasma creatinine levels independent of any effects on glomerular filtration rate (GFR).

Methods: At a tertiary hospital 110 cardiac surgical patients were randomly allocated to peri-operative infusion of NAC (300 mg/kg over 24 h, N = 30) or placebo (N = 80). We compared the plasma concentrations of creatinine, cystatin C and urea, the plasma creatinine/plasma cystatin C ratio and the estimated GFR at baseline and at 24 and 72 h after commencement of the infusion. We measured urinary creatinine concentration at 24 h.

Results: At baseline, the plasma creatinine/plasma cystatin C ratio did not differ between the NAC and placebo group (0.90 versus 0.92; P = 0.94). There was no significant difference in the plasma creatinine/plasma cystatin C ratio for the NAC and placebo group either during or after NAC infusion at 24 h (1.03 versus 1.00; P = 0.78) and 72 h (0.94 versus 0.89; P = 0.09). Those allocated to NAC showed no difference in urinary creatinine excretion when compared to placebo (P = 0.24).

Conclusions: The results of our study do not demonstrate that NAC artifactually lowers creatinine measured using the Jaffé method. 
Keyword Acute kidney injury
Contrast-induced nephropathy
Cystatin C
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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