Effect of N-acetylcysteine on antimicrobials induced nephrotoxicity: a meta-analysis

source extracted confidence: high 2026-04-09
#acetylcysteine #humans #anti-infective-agents #acute-kidney-injury #randomized-controlled-trials-as-topic

Effect of N-acetylcysteine on antimicrobials induced nephrotoxicity: a meta-analysis

Qiu et al., 2025 | BMC Nephrol | Meta Analysis

Citation

Qiu Xianming, Yang Shenao, ... Zhou Lei. Effect of N-acetylcysteine on antimicrobials induced nephrotoxicity: a meta-analysis. BMC Nephrol. 2025-Mar-08;26(1):128. doi:10.1186/s12882-025-04037-y

Abstract

OBJECTIVE: N-acetylcysteine (NAC) has antioxidant effects in reducing acute kidney injury. This study systematically reviewed and assessed the efficacy of NAC in preventing antimicrobials induced nephrotoxicity. METHODS: Pubmed, Embase, Web of Science, and the Cochrane Library were searched extensively for relevant studies that evaluating NAC on antimicrobials induced nephrotoxicity until June 1, 2024. Eligible records were screened according to the inclusion and exclusion criteria. The odds ratio (OR) was selected to evaluate the effect of NAC on nephrotoxicity. We pooled the extracted data using a random effects model. RESULTS: Three randomized controlled trials were included in the analysis. The pooled results showed that NAC could reduce the incidence of antimicrobials induced nephrotoxicity (OR = 0.487, 95% CI = 0.258, 0.918, P = 0.03, I2 = 0%). Serum creatine (Scr) on Day 2 was significantly decreased in the NAC group compared to the placebo group (SMD, - 0.298; 95%CI, - 0.585 to - 0.010; I2 = 23%; P = 0.04). No difference was observed in blood urea nitrogen (BUN), and creatinine clearance (CrCl). CONCLUSION: In this meta-analysis, NAC was associated with a benefit in the prevention of antimicrobials induced nephrotoxicity. However, large-scaled and well-designed RCTs are required in the future.

Key Findings

Three randomized controlled trials were included in the analysis. The pooled results showed that NAC could reduce the incidence of antimicrobials induced nephrotoxicity (OR = 0.487, 95% CI = 0.258, 0.918, P = 0.03, I2 = 0%). Serum creatine (Scr) on Day 2 was significantly decreased in the NAC group compared to the placebo group (SMD, - 0.298; 95%CI, - 0.585 to - 0.010; I2 = 23%; P = 0.04). No difference was observed in blood urea nitrogen (BUN), and creatinine clearance (CrCl).

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Acetylcysteine
  • Humans
  • Anti-Infective Agents
  • Acute Kidney Injury
  • Randomized Controlled Trials as Topic
  • Creatinine
  • Antioxidants

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: creatine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09