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Effect of N-Acetylcysteine on hsCRP in Patients on Continues Ambulatory Peritoneal Dialysis: A Quasi-Experimental Study

Background: Inflammatory processes are proved in patients with chronic kidney disease (CKD) as one of the leading causes of mortality and morbidity. N-acetylcysteine (NAC) is known as an antioxidant drug with anti-inflammatory effects. Objectives: This study aimed to evaluate the effects of NAC on hsCRP in CKD patients on peritoneal dialysis. Methods: This quasi-experimental self-controlled study examined adult CKD patients on peritoneal dialysis referred to the peritoneal dialysis clinic. The participants were assigned into two groups (A: CRP of 5 - 15 mg/L and B: CRP < 5 mg/L), and both groups were treated with oral NAC 600mg twice a day for eight weeks. First, the hsCRP was measured before and after the intervention, and then all the collected data were analyzed. Results: Forty patients (n = 24 in the group A and n = 26 in the group B) participated in this study. NAC decreased the hsCRP level in both groups (P = 0.001 in the group A vs. P = 0.002 in group B); however, the decrease was more prominent in the group A (P = 0.013). The hsCRP decrease was more significant in women (P = 0.002) in general and women in the group B (P = 0.02) in particular. The hsCRP variation had a significant relationship with the underlying disease (P = 0.009). There was no significant correlation between the hsCRP variation with age (r = -0.173, P = 0.285) and the duration of dialysis. Conclusions: The administration of NAC (600 mg, twice a day for eight weeks) significantly decreased the level of hsCRP in patients on peritoneal dialysis, especially in those with CRP = 5 - 15 mh/L. The decrease has no relationship with age and duration of dialysis; however, it was more highlighted in women.