Background: Postoperative acute kidney injury (AKI) is a common complication that impact on outcome of endovascular abdominal aortic aneurysm repair (EVAR). N-acetylcysteine (NAC) proposed to have benefit on preventing and reducing kidney injury. Unfortunately previous studies show controversial outcome. In this study, we randomized patients planned for EVAR take NAC with normal saline solution (NSS) intravenously or placebo with NSS measure for postoperative declination of kidney function postoperatively.
Objective: To investigate the effect of N-acetylcysteine on preventing and reducing postoperative kidney injury of EVAR
Methods: A randomized, placebo-controlled, double-blind trial with the following inclusion criteria: abdominal
aortic aneurysm repair in patients. The groups were randomly matched for age, gender, presence of diabetes and pre-existent renal failure. NAC or placebo (control) was administered I.V. for 1 h before operation and maintained i.v. for 48 h after operation. The dose of NAC was 1200mg I.V. loading the day before EVAR and 2400mg per day after. The primary endpoint was the development of acute kidney injury (AKI) up
to the third post-operative day, defined as KDIGO classification. Secondary endpoints were: perioperative mortality and morbidities and ICU length of stay.
Conclusions: N-acetylcysteine may not prevent postoperative kidney injury but show to have beneficial effect on reducing severity of postoperative kidney injury among patients undergo EVAR.
Key words: Randomized controlled study, endovascular repair, EVAR, abdominal aortic aneurysm, acute kidney injury, N-acetylcysteine