Mustafa Aldemir
Kocatepe University, Turkey
Posters-Accepted Abstracts: Surgery Curr Res
Objective: Recent conflicting studies on the renal effects of N-acetyl cysteine (NAC) after cardiac surgery have been published. The aim of this study was to evaluate the renal effects of NAC using neutrophil gelatinase-associated lipocalin (NGAL) blood levels in elderly patients undergoing coronary artery bypass surgery. Methods: This randomized, double-blinded, placebo-controlled study was conducted among geriatric patients (>65 years) scheduled for CABG. A total of 60 consecutive patients were randomly assigned into two groups. The first group received I.V. NAC (n=30) and the second group received placebo (n=30) at induction of anaesthesia and then for 20 hrs. NGAL values were determined and conventional renal function tests were performed. Results: Plasma creatinine level at the P.O. 24th hr was significantly higher in the placebo group than the NAC group (1.41±0.63 vs. 1.13±0.35, p<0.05). The mean serum NGAL level in the third postoperative hour was higher in the placebo group than in the NAC group (104.94±30.51 vs. 87.82±25.18, p<0.05). Its level was similar at all other measurement times for the two groups. The number of patients (%) with increased plasma creatinine �1.5 mg/dL or >25% of the baseline value at any time of the study period was 27% in the NAC group and 37% in the placebo group, which was statistically significant (p<0.05). Conclusion: In the present study, we found that I.V. N-acetylcysteine infusion in elderly patients undergoing coronary artery by-pass surgery reduced the incidence of acute kidney injury as determined by blood NGAL and creatinine levels.
