STUDY TO COMPARE THE THERAPEUTIC EFFICACY OF N-ACETYL CYSTEINE AND COMBINATION OF N-ACETYL CYSTEINE AND TAURINE IN PROTEINURIA IN DIABETIC NEPHROPATHY

  • Akhilesh Kumar Singh S.N. MEDICAL COLLEGE
  • Prabhat Agarwal S.N. Medical college Agra
  • Saurabh Kaushik S.N. Medical college, Agra

Abstract

Objective: Proteinuria is an established risk factor for progressive damage of kidney. This proteinuria can be effectively controlled by drugs that interrupt the renin–angiotensin–aldosterone system. However, the efficacy of N-acetyl cysteine (NAC) and taurine in prevention of diabetic nephropathy (DN) is uncertain. The role of NAC and taurine in reducing of proteinuria in patients with DN was studied.

Methods: The present study was undertaken in the Postgraduate Department of Medicine of S.N. Medical College, Agra. A total of 60 patients of diabetes mellitus with evidence of nephropathy were included in the study. Twenty patients were given placebo medication (Group P), 20 patients received NAC (Group A), and remaining 20 received a combination of NAC and taurine (Group B). Each group was further subdivided according to the urinary albumin excretion in 24 hrs. Subgroup 1 - Urinary albumin excretion between 30 and 300 mg/24 hrs. Subgroup 2 - Urinary albumin excretion >300 mg/24 hrs. The stastical analysis used Student’s t-test.

Results: On comparison, in both microalbuminuria and macroalbuminuria patients divided into three groups; the difference in magnitude of increase in proteinuria (after NAC, NAC with taurine, and placebo administration) over 24 weeks of the study period was statistically insignificant.

Conclusions: In this study, there was no significant difference of proteinuria before and after NAC administration, and also in our study, there was no significant difference of proteinuria before and after taurine administration.

Keywords: Albuminuria, Diabetic nephropathy, N-acetyl cysteine, Taurine.

Author Biographies

Akhilesh Kumar Singh, S.N. MEDICAL COLLEGE
assistant professor , p.g. deptt. of medicine , SNMC agra
Prabhat Agarwal, S.N. Medical college Agra
associate professor, p.g. deptt. of medicine , SNMC Agra
Saurabh Kaushik, S.N. Medical college, Agra
resident third(3rd) year , p.g. deptt. of medicine, SNMC Agra

References

1. Hasslacher C, Ritz E, Wahl P, Michael C. Similar risks of nephropathy in patients with type I or type II diabetes mellitus. Nephrol Dial Transplant 1989;4:859-63.
2. Berger M, Mönks D, Wanner C, Lindner TH. Diabetic ephropathy: An inherited disease or just a diabetic complication? Kidney Blood Press Res 2003;26:143-54.
3. Parving HH. Diabetic nephropathy: Prevention and treatment. Kidney Int 2001;60:2041-55.
4. Wolf G. New insights into the pathophysiology of diabetic nephropathy: From haemodynamics to molecular pathology. Eur J Clin Invest 2004;34:785-96.
5. Mason RM, Wahab NA. Extracellular matrix metabolism in diabetic nephropathy. J Am Soc Nephrol 2003;14:1358-73.
6. Shumway JT, Gambert SR. Diabetic nephropathy-pathophysiology and management. Int Urol Nephrol 2002;34:257-64.
7. Wolf G, Ziyadeh FN. Cellular and molecular mechanisms of proteinuria in diabetic nephropathy. Nephron Physiol 2007;106:26-31.
8. Balakumar P, Chakkarwar VA, Krishan P, Singh M. ascular endothelial dysfunction: A tug of war in diabetic nephropathy? iomed Pharmacother 2009;63:171-9.
9. Brown NJ, Vaughan DE. Angiotensin-converting enzyme inhibitors. Circulation 1998;97:1411-20.
10. Stevens MA, Mccullough PA, Tobin KJ, Speck JP, Westveer DC, Guido-Allen DA, et al. A prospective randomized trial of prevention measures in patients at high risk for contrast nephropathy: Results of the P.R.I.N.C.E. study. Prevention of radiocontrast induced nephropathy clinical evaluation. J Am Coll Cardiol 1999;33:403-11.
11. Gare M, Haviv YS, Ben-Yehuda A, Rubinger D, Bdolah-Abram T, Fuchs S, et al. The renal effect of low-dose dopamine in high- risk patients undergoing coronary angiography. J Am Coll Cardiol
1999;34:1682-8.
12. Hall KA, Wong RW, Hunter GC, Camazine BM, Rappaport WA, Smyth SH, et al. Contrast-induced nephrotoxicity: The effects of vasodilator therapy. J Surg Res 1992;53:317-20.
13. Solomon R, Werner C, Mann D, D’Elia J, Silva P. Effects of saline, mannitol, and furosemide to prevent acute decreases in renal function induced by radiocontrast agents. N Engl J Med 1994;331:1416-20.
14. Seyss C, Foote EF. Calcium-channel blockers for prophylaxis of radiocontrast-associated nephrotoxicity. Ann Pharmacother 1995;29:187-8.
15. Abizaid AS, Clark CE, Mintz GS, Dosa S, Popma JJ, Pichard AD, et al. Effects of dopamine and aminophylline on contrast-induced acute renal failure after coronary angioplasty in patients with pre-existing renal insufficiency. Am J Cardiol 1999;83:260-3.
16. Conessa EL, Valero F, Nadal JC, Fenoy FJ, López B, Arregui B, et al. N-acetyl-L-cysteine improves renal medullary hypoperfusion in acute renal failure. Am J Physiol Regul Integr Comp Physiol
2001;281:R730-7.
17. DiMari J, Megyesi J, Udvarhelyi N, Price P, Davis R, Safirstein R.
N-acetyl cysteine ameliorates ischemic renal failure. Am J Physiol
1997;272:F292-8.
18. Hamada Y, Miyata S, Nii-Kono T, Kitazawa R, Kitazawa S, Higo S, et al. Overexpression of thioredoxin1 in transgenic mice suppresses development of diabetic nephropathy. Nephrol Dial Transplant 2007;22:1547-57.
19. Ha H, Yu MR, Kim KH. Melatonin and taurine reduce early glomerulopathy in diabetic rats. Free Radic Biol Med
1999;26(7-8):944-50.
20. Trachtman H, Del-Pizzo R, Futterweit S, Levine D, Rao PS, Valderrama E, et al. Taurine attenuates renal disease in chronic puromycin aminonucleoside nephropathy. Am J Phsiol 992;262:F117-23.
21. Trachtman H, Futterweit S, Maesaka J, Ma C, Valderrama E, Fuchs A, et al. Taurine ameliorates chronic streptozocin-induced diabetic nephropathy in rats. Am J Physiol 1995;269:F429-38.
22. Lee EA, Seo JY, Jiang Z, Yu MR, Kwon MK, Ha H, et al. Reactive oxygen species mediate high glucose-induced plasminogen activator inhibitor-1 up-regulation in mesangial cells and in diabetic kidney. Kidney Int 2005;67:1762-71.
23. Ng TM, Shurmur SW, Silver M, Nissen LR, O’Leary EL, Rigmaiden RS, et al. Comparison of N-acetylcysteine and fenoldopam for preventing contrast-induced nephropathy (CAFCIN). Int J Cardiol
2006 24;109:322-8.
24. Saklayen MG, Yap J, Vallyathan V. Effect of month-long treatment with oral N-acetylcysteine on the oxidative stress and proteinuria in patients with diabetic nephropathy: A pilot study. J Investig Med 2010;58:28-31.
25. Studer RK, Craven PA, DeRubertis FR. Antioxidant inhibition of protein kinase C-signaled increases in transforming growth factor-beta in mesangial cells. Metabolism 1997;46:918-25.
Statistics
351 Views | 843 Downloads
How to Cite
Singh, A. K., P. Agarwal, and S. Kaushik. “STUDY TO COMPARE THE THERAPEUTIC EFFICACY OF N-ACETYL CYSTEINE AND COMBINATION OF N-ACETYL CYSTEINE AND TAURINE IN PROTEINURIA IN DIABETIC NEPHROPATHY”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 10, no. 2, Feb. 2017, pp. 230-2, doi:10.22159/ajpcr.2017.v10i2.15369.
Section
Original Article(s)