The effect of treatment with N-acetylcysteine on the serum levels of C-reactive protein and interleukin-6 in patients on hemodialysis

Abstract EN

Patients with end-stage renal disease (ESRD) are at an increased risk of cardiovascular disease due to many factors including inflammation and oxidative stress.

N-acetylcysteine (NAC) is a thiol-containing anti-oxidant with anti-inflammatory properties.

We aimed to assess the effect of three months treatment with oral NAC on the plasma levels of inflammatory mediators like interleukin-6 (IL-6) and C-reactive protein (hs-CRP) in patients on hemodialysis (HD).

Twenty-four patients (nine males and 15 females) on maintenance HD were recruited in the study.

Their mean age was 55.3 years.

All the patients received oral NAC (600 mg twice a day) for a period of three months.

The serum levels of biomedical parameters and IL-6 and hs-CRP were measured at baseline and three months after initiation of treatment.

A significant decrease in serum levels of hs-CRP (22.4 vs.

5.2), IL-6 (8.1 vs.

3.6), parathyroid hormone (iPTH) (257.2 vs.

158.8), ferritin (632.0 vs.

515.1) and erythrocyte sedimentation rate (ESR) (54.2 vs.

38.3) was observed following NAC treatment.

Female subjects presented with a significantly higher change in serum levels of hs-CRP compared with males (23 vs.

5.4).

In three subjects who were less than 40 years old, the hs-CRP and IL-6 levels showed an increase following NAC treatment.

Our study found that short-term oral NAC treatment might result in the reduction of IL-6 and hs-CRP in patients who are on regular HD.

This suggests that patients with ESRD may benefit from the antiinflammatory effects of NAC.