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October 3, 2017Fluids and Barriers of the CNSOpen Access

The maximum tolerated dose of NAC was 450 mg/kg for both IV and IA administration, with grade 4 toxicity observed at 600 mg/kg IV.

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Why the study?

What is the maximum tolerated dose of intravenous and intra-arterial N-acetylcysteine in adults with chronic kidney disease?

Population

28 adults with stage 3 or worse renal failure who had any endovascular procedure

Design

Cohort, non-randomized

Authors

EDEdit DósaKHKrisztina HeltaiTRTamás Radovits

Discussion

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Overview

Supports further NAC investigation for cisplatin ototoxicity in children; leaves open clinical adoption pending larger trials.

Structured PICO

What is the maximum tolerated dose of intravenous and intra-arterial N-acetylcysteine in adults with chronic kidney disease?

P
Population
28 adults (15 men; mean age 72.2 ± 6.8 years) with stage 3 or worse renal failure who had any endovascular procedure
I
Intervention
N-acetylcysteine (NAC) administered intravenously (IV, n=13) or intra-arterially (IA, n=15) at escalating doses (150, 300, 450, 600, 900, and 1200 mg/kg)
O
Outcome
Maximum tolerated dose (MTD) of NAC, defined as one dose level below the dose producing grade 3 or 4 toxicitysafety

In adults with kidney impairment undergoing endovascular procedures, the maximum tolerated dose of N-acetylcysteine is 450 mg/kg for both intravenous and intra-arterial administration.

Cite This Study

Dósa et al. (2017) studied this question.

synapsesocial.com/papers/6a6fef10e5469ee92be0bb60https://doi.org/10.1186/s12987-017-0075-0
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Also Consider

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  3. 3N-Acetylcysteine Role in Maintaining Renal Function in Cancer Patients with Cisplatin-Based Chemotherapy2025 · 2 citations
  4. 4N-acetylcysteine Attenuates Cisplatin Toxicity in Cerebrum and Lung of Young Rats with Artificially Produced Protein Deficiency2024 · 1 citations
  5. 5Abstract 1250: N-acetylcysteine pharmacokinetics and neuroprotection in a translational ovarian cancer model of cancer-related cognitive impairment.2026