Drug Nephrotoxicity Amelioration by N-acetylcysteine

Last updated: July 3, 2024
Sponsor: Helwan University
Overall Status: Completed

Phase

N/A

Condition

N/A

Treatment

N Acetylcysteine

Clinical Study ID

NCT06122311
ANP
  • Ages > 18
  • All Genders

Study Summary

When treating individuals with febrile neutropenia, amphotericin B (AmB-d) is one of the most effective treatments against often fatal systemic fungal infections.Nephrotoxicity from amphotericin B can develop with an incidence of up to 80.This emphasizes the value of nephroprotectant agent use.Because of N-acetylcysteine's antioxidant, antiapoptotic, vasodilator properties and its therapeutic effects on contrast nephropathy. Acetylcysteine's impact on amphotericin B-induced nephrotoxicity in cancer patients is assessed.

Eligibility Criteria

Inclusion

Inclusion Criteria:

  • Age more than 18 years.

  • Patients who have indication for systemic (injection) for conventional amphotericinat least 7 days.

Exclusion

Exclusion Criteria:

  • documented acute kidney injury defined by an increase in serum creatinine ‡ 0.3mg/dl within 48 h, or an increase in serum creatinine by ‡ 1.5 times baseline withinthe prior 7 days, or urine volume <0.5 ml/kg/h for 6 h

  • documented chronic kidney disease (clearance creatinine below 60 ml/min/1.73 m2calculated by the abbreviated Modification of Diet in Renal Disease equation),history of peritoneal or hemodialysis for > 3 months

  • sepsis

  • Severe hemorrhage(Blood loss > 3 litres)

  • Patient with cardiac or chronic liver disease history of receiving AmB by anyadministration route within the recent 14 days known allergy to either amphotericinb or N-acetylcysteine.

  • receiving any formulation of NAC within the last week.

  • unable to tolerate oral intake.

Study Design

Total Participants: 100
Treatment Group(s): 1
Primary Treatment: N Acetylcysteine
Phase:
Study Start date:
August 25, 2023
Estimated Completion Date:
June 10, 2024

Study Description

Severe fungal infections continue to be a significant source of morbidity and mortality in haematology units despite recent therapeutic advancements. The first anti-fungal medication that was successful against systemic mycoses was characterised as the traditional amphotericin B in the middle of the 1950s.AMB remains the treatment of choice for many serious fungal infections in vulnerable hosts owing to its excellent spectrum of activity and its low resistance rates. To date, it continues to be the agent with the widest spectrum of action and the lowest resistance potential of any known antifungal agent.In spite of clinical effectiveness, AmB treatment is associated with a range of acute and chronic adverse reactions . Nephrotoxicity and consequent electrolytes imbalances have been demonstrated as the most clinically significant adverse reaction of AmB that can restrict its clinical utility. Up to 80 % of AmB recipients during the first two weeks of treatment may develop some degree of reversible kidney injury . In addition, nearly 15 % of these patients may require dialysis which can lead to prolongation of hospital stay, increased total treatment costs, and mortality .

N-acetylcysteine, a drug with vasodilating, antiapoptotic, and anti-oxidant features, has been found to diminish the nephrotoxicity of cisplatin , cyclosporine and gentamicin . The results of two experimental studies in rats have suggested that N-acetylcysteine can mitigate GFR reduction as well as renal tubular apoptosis caused by AmB .

Connect with a study center

  • Helwan University

    Cairo,
    Egypt

    Site Not Available

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