EFFECTS OF N-ACETYL CYSTEINE ON PROTEINURIA IN TYPE 2 DIABETIC PATIENTS WITH DIABETIC NEPHROPATHY

Dr. Hossain Muhammad Mustafijur Rahman*, Prof. Dr. Md. Nizamuddin Chowdhury, Prof. Dr. Md. Nazrul Islam, Dr. Md. Aminul Islam, Dr. G. M. Hafizur Rahman, Dr. Faruque Ahmed, Dr. Md. Tanvir Rahman, Dr. Nahid Afrin and Dr. Sheikh Mohammad Samsuzzaman

ABSTRACT

Background: Diabetic nephropathy is one of the leading cause of ESRD. Limited drugs are available to reduce proteinuria in diabetic nephropathy. It is thought that N-acetyl Cysteine (NAC) has anti-proteinuric effect.Objective: To assess the effect of N-acetyl Cysteine (NAC) on proteinuria in type 2 diabetic patients with diabetic nephropathy. Methods: This is a prospective interventional study and conducted at the Department of Nephrology in DMCH. Total 65 patients were included in the study and they were divided into two groups named control (Group I, n = 33) and intervention group (Group II, n = 32). Then Group II was given NAC (oral 600mg twice daily) for two months in addition to standard medication and Group I was only on proper doses of standard medication. Data were collected at day 0 and at day 60. Comparison of the two groups were done to find out the effect of N-acetyl Cysteine.Results: At the beginning ( Day 0), mean albumin/creatinine ratio (ACR) in Group I and Group II were 405.80±488.89 SD and 501±568.75 SD respectively. A significant reduction of ACR value was noted in Group II after intervention (p value <0.001). But in Group I there was mild rise in ACR at Day 60 which was insignificant (p value 0.51). Whereas, a significant reduction of protein creatinine ratio (PCR) was noted in both Group I (p < 0.04) and Group II (0.001) at Day 60. The reduction in Group II was highly significant. Conclusion: NAC significantly reduces proteinuria in diabetic nephropathy patients.

Keywords: Anti-proteinuric drug, N-Acetyl Cysteine (NAC), Drug treatment of diabetic nephropathy.