Original Paper

N-Acetylcysteine Improves Arterial Vascular Reactivity in Patients with Chronic Kidney Disease
Antje Wittstock, Magdalena Burkert, Walter Zidek, Martin Tepel, Alexandra Scholze

Medizinische Klinik Nephrologie, Charité Campus Benjamin Franklin, Berlin, Deutschland

Address of Corresponding Author

Nephron Clin Pract 2009;112:c184-c189 (DOI: 10.1159/000218107)

  Key Words

• Antioxidant
• Acetylcysteine
• Arterial vascular reactivity
• Stage 5 chronic kidney disease

  Abstract

Background: Patients with stage 5 chronic kidney disease show increased cardiovascular morbidity and mortality that are partly related to impaired arterial vascular reactivity. We investigated whether intravenous administration of the antioxidant acetylcysteine improves arterial vascular reactivity in these patients. Methods: Arterial vascular reactivity was determined during reactive hyperemia by photoplethysmography of digital pulse waves in a randomized, prospective, placebo-controlled cross-over study of 24 patients with stage 5 chronic kidney disease with and without infusion of acetylcysteine during hemodialysis. Acetylcysteine (5 g in 5% glucose in a final volume of 50 ml) was continuously administered intravenously during one hemodialysis session. Results: In the absence of acetylcysteine, the reflective index was 38.5 ± 9.4 (mean ± SD; n = 24) at baseline and 33.8 ± 9.9 during reactive hyperemia, immediately after the hemodialysis session; thus there was no significant vasodilatation (p > 0.05), indicating impaired arterial vascular reactivity in these patients. However, when the hemodialysis session in the same patients was performed in the presence of acetylcysteine, the reflective index significantly decreased from 37.9 ± 8.6 at baseline to 30.2 ± 10.3 during reactive hyperemia (n = 24; p < 0.01). Conclusion: The present study shows that intravenous administration of acetylcysteine during hemodialysis significantly improves arterial vascular reactivity during reactive hyperemia.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Dr. Martin Tepel
Charité Campus Benjamin Franklin, Med. Klinik IV
Hindenburgdamm 30
DE-12200 Berlin (Germany)
Tel. +49 30 8445 2305, Fax +49 30 8445 4235, E-Mail Martin.Tepel@charite.de

  Article Information

Received: September 30, 2008
Accepted: November 12, 2008
Published online: May 13, 2009
Number of Print Pages : 6
Number of Figures : 2, Number of Tables : 1, Number of References : 29