Abstract
N-Acetylcysteine Interference With Creatinine Measurement: An In Vitro Analysis
Highlights
-acetylcysteine (NAC) is a derivative of the cysteine amino acid, and was introduced in the 1960s primarily as a mucolytic,[1] for which it is still used orally as well as in a nebulized form. It can serve as a substrate for glutathione synthesis, which has an antioxidant property, and is depleted in states such as acetaminophen intoxication.[2]
N -acetylcysteine (NAC) is used as an antidote in the intravenous form in this setting, as well as increasingly in severe alcoholic hepatitis, with some evidence of benefit.[3]
One possible explanation for the discrepancy in outcomes with NAC in the AKI literature could be related to the measurement of creatinine, since notably in the contrast-induced acute kidney injury (CI-AKI) trials, the benefit was mostly seen in trials with a change in creatinine as an outcome, and not in clinical outcomes such as need for dialysis or death
Summary
-acetylcysteine (NAC) is a derivative of the cysteine amino acid, and was introduced in the 1960s primarily as a mucolytic,[1] for which it is still used orally as well as in a nebulized form. With the hypothesis that the method of measuring creatinine may influence the interference of NAC on creatinine measurement, we conducted this in vitro study by adding specific concentration of NAC to blood samples with known different levels of creatinine and measuring creatinine again with different methods, as well as measuring other markers of kidney function. The Jaffe creatinine method was unaffected by NAC addition (Supplementary Figure S1).
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