Intravenous administration of N-acetylcysteine reduces plasma total homocysteine levels in renal transplant recipients.

BACKGROUND: Hyperhomocysteinemia occurs in approximately 60-70% of renal transplant recipients and is associated with increased risk of cardiovascular events, mortality and kidney allograft loss. In normal subjects N-acetylcysteine (NAC) given either orally or intravenously markedly reduces plasma total homocysteine (tHcy) level. In cardiac transplant recipients it was reported, that oral treatment with NAC does not affect Hcy levels. We have therefore, investigated the effect of intravenous NAC on plasma tHcy levels in renal transplant recipients.

MATERIAL/METHODS: Eleven renal transplant recipients who had normal plasma levels of vitamin B12 and folic acid, were treated with intravenous NAC or placebo in a crossover manner.

RESULTS: Intravenous administration of NAC significantly reduced plasma tHcy (p=0.0008). Decrease in tHcy was related to its initial concentration.

CONCLUSIONS: Intravenous NAC profoundly reduces tHcy level in renal transplant recipients. Further research is needed to establish the effect of orally administered NAC on plasma homocysteine concentration in this clinical condition.