The Effect of N-Acetylcysteine on Glomerulus Filtration Rate in Patients with Chronic Kidney Disease Post Percutaneous Coronary Intervention
Abstract
The use of contrast for percutaneous coronary intervention (PCI) procedures in chronic kidney disease (CKD) patients can worsen kidney function. N-Acetylcysteine is widely used as a preventive therapy for contrast-induced nephropathy (CIN). However, previous studies have shown inconsistent results, so that further research regarding the effectiveness of N-Acetylcysteine to prevent CIN is needed. This study aimed to determine the effect of N-Acetylcysteine on glomerulus filtration rate (GFR) in patients with CKD who underwent PCI. This research was conducted at Jakarta's national central general hospitals from July to December 2019 with a retrospective study design. Through the purposive sampling method, we obtained 72 samples. The sample was selected from the patient's medical records in the period January-June 2019. Patients who underwent PCI and had a history of CKD were included in the study. The data were analyzed by t and chi-square tests to determine the effect of N-Acetylcysteine on the patient's GFR. The results showed that CKD patients underwent PCI were dominated by male (61.11% vs 38.89%) and 33.33% of patients aged 55-64 years. Most patients had GFR values between 30-59.99 ml/min/1.73m2 with 100 ml of contrast administration. The ratio of contrast amount to GFR > 3.7 was found in 47.22% of patients. The administration of N-Acetylcysteine as a preventive therapy for CIN post-PCI increased the GFR value of CKD patients by 2.69±5.72. N-Acetylcysteine had a significant effect on the GFR of post-PCI CKD patients (p=0.000).
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Kementerian Kesehatan RI. Laporan Nasional Riskesdas 2018. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI; 2019. 674 p.
Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. Pedoman Nasional Pelayanan Kedokteran Intervensi Koroner Perkutan. 2021. 41 p.
Anwar MR, Hai ANMA, Debnath DK, Faraji MAH, Hasan KM. Incidence and Risk Factors of Contrast Induced Nephropathy in Patients Following Coronary Angiography. Journal of Science Foundation. 2017;15(1):20–5.
Hossain MA, Costanzo E, Cosentino J, Patel C, Qaisar H, Singh V, et al. Contrast-induced nephropathy: Pathophysiology, risk factors, and prevention. Saudi Journal of Kidney Diseases and Transplantation. 2018 Jan 1;29(1):1.
Kovar F, Knazeje M, Mokan M. Contrast-Induced Nephropathy: Risk Factors, Clinical Implication, Diagnostics Approach, Prevention [Internet]. What Should We Know About Prevented, Diagnostic, and Interventional Therapy in Coronary Artery Disease. IntechOpen; 2013 [cited 2021 Jul 15]. Available from: https://www.intechopen.com/books/what-should-we-know-about-prevented-diagnostic-and-interventional-therapy-in-coronary-artery-disease/contrast-induced-nephropathy-risk-factors-clinical-implication-diagnostics-approach-prevention
Parlindungan HW, Hasan R, Andra CA, Akbar NZ, Nasution AN, Hasan H, et al. CHA2DS2-VAS-HSF Score as a Predictor for Contrast- Induced Nephropathy in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention. Indonesian Journal of Cardiology [Internet]. 2018 [cited 2021 Jul 15];39(2). Available from: https://www.ijconline.id/index.php/ijc/article/view/766
Pintaningrum Y. Komplikasi Intervensi Koroner Perkutan. Jurnal Kedokteran [Internet]. 2016 [cited 2021 Jul 15];5(4). Available from: http://jku.unram.ac.id/article/view/9
Eskandarian R, Yarmohamadi M, Zaker-Tavalae M, Mirmohammadkhani M, Biglari M, Tamadon MR, et al. The standard dose versus double dose of N-acetylcysteine to prevent contrast-induced nephropathy; a randomized controlled clinical trial. J Nephropathol. 2018 May 25;7(3):145–50.
Simatupang LD, Susalit E, Wijaya IP. Peran Kombinasi Hidrasi dan N-Acetyl Cysteine terhadap Nefropati akibat Kontras 48 Jam Pasca Percutaneous Coronary Intervention pada Pasien Penyakit Ginjal Kronik Stadium 3. Jurnal Penyakit Dalam Indonesia. 2016 Sep 30;3(3):125–30.
Neumann F-J, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019 Jan 7;40(2):87–165.
Xu R, Tao A, Bai Y, Deng Y, Chen G. Effectiveness of N-Acetylcysteine for the Prevention of Contrast-Induced Nephropathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc. 2016 Sep 23;5(9):e003968.
Opitasari C, Rif’ati L. Penyakit Kardiovaskular pada Pasien Rawat Inap Dewasa: Studi Kasus dari Data Klaim BPJS Rumah Sakit Pemerintah di Jakarta. Media Penelitian dan Pengembangan Kesehatan [Internet]. 2021 Mar 31 [cited 2021 Jul 20];31(1). Available from: https://ejournal2.litbang.kemkes.go.id/index.php/mpk/article/view/3291
Dewi VA, Musthafa Z, Bustamam N. Analisis Komparatif Akses Vaskular terhadap Kejadian Hematoma Pasca Percutaneous Coronary Intervention dengan Pemasangan Stent pada Pasien Acute Coronary Syndrome di RSPAD Gatot Subroto. Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan [Internet]. 2015 [cited 2021 Jul 15];9(1). Available from: https://ejournal.upnvj.ac.id/index.php/JPM/article/view/821
Perhimpunan Dokter Spesialis Kardiovaskular Indonesia. Pedoman Tata Laksana Sindrom Koroner Akut. 4th ed. 2018. 94 p.
Sagita TC, Setiawan AA, Hardian H. Hubungan Derajat Keparahan Gagal Ginjal Kronik dengan Kejadian Penyakit Jantung Koroner. DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO). 2018;7(2):472–84.
Wijaya AT, Atmadja B. Identifikasi Risiko dan Pencegahan Terhadap Nefropati Akibat Kontras. Jurnal Radiologi Indonesia. 2016;2(1):52–8.
Xie W, Liang X, Lin Z, Liu M, Ling Z. Latest Clinical Evidence About Effect of Acetylcysteine on Preventing Contrast-Induced Nephropathy in Patients Undergoing Angiography: A Meta-Analysis. Angiology. 2021 Feb;72(2):105–21.
DOI: https://doi.org/10.15416/ijcp.2022.11.3.217
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