Does N-Acetylcysteine Prevent Acute Renal Failure in Critically Ill Patients?

Acute tubular necrosis, most commonly resulting from hypotension, is responsible for most of the morbidity and mortality associated with acute renal failure (ARF) in critically ill patients. In previous studies, administration of N-acetylcysteine was associated with a decrease in the degree of organ failure in septic patients and with a reduction in the incidence of intravenous contrast dye–induced nephropathy in high-risk patients with chronic renal disease. These authors hypothesized that N-acetylcysteine would reduce the incidence of ARF and improve recovery from compromised kidneys in hypotensive patients.

In a randomized, double-blind, controlled study, 142 hypotensive intensive-care-unit patients received oral N-acetylcysteine or place…