N-Acetylcysteine's Renoprotective Effect in Cardiac Surgery: A Systematic Review and Meta-Analysis
Tan, Ying Kiat ; Luo, HaiDong ; Kang, Giap Swee ; Teoh, Kristine LK ; Kofidis, Theo
Tan, Ying Kiat
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Abstract
Objective: To examine N-acetylcysteine’s (NAC’s) renoprotective effect in adult cardiac surgery Methods: PubMed, Ovid Medline, and Embase were searched for randomized controlled trials published between January 1990 and May 2021 that investigated the effect of NAC in preventing acute kidney injury (AKI) in patients undergoing cardiac surgery. The inclusion criterion was studies that assessed the effect of NAC in comparison to placebo by measuring the incidence of AKI. Results: Overall meta-analytic estimates of all 10 included trials showed that NAC did not have a significant effect (odds ratio [OR]: 0.84, 95% confidence interval [CI]: 0.64–1.10) on AKI. Further subgroup analysis did not show a significant benefit of NAC in preventing AKI. Conclusion: This meta-analysis suggests that NAC does not have a significant effect in reducing the incidence of AKI. However, there is notable heterogeneity among the included studies that could possibly account for the non-significant effect observed. It is worth noting that only one trial administered NAC high dosages perioperatively, and it is the only included trial to show a significant benefit in reducing the incidence of AKI (OR: 0.30, 95% CI: 0.11–0.81). Further studies on this dosage and duration of administration should be conducted to best elucidate the effect of administering NAC.
Keywords
Science & Technology, Life Sciences & Biomedicine, Cardiac & Cardiovascular Systems, Surgery, Cardiovascular System & Cardiology, cardiac surgery, acute kidney injury, N-acetylcysteine, Commons Attribution-NonCommercial-, ACUTE KIDNEY INJURY, PREVENT RENAL DYSFUNCTION, HIGH-RISK PATIENTS, CONTROLLED-TRIAL, FAILURE, BYPASS
Source Title
ANNALS OF THORACIC AND CARDIOVASCULAR SURGERY
Publisher
Int Acad Publishing Co Ltd
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Date
2022-01-01
DOI
10.5761/atcs.oa.21-00132
Type
Review