Nurina Hasanatuludhhiyah, Achmad Basori

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Oxidative injury produced via Fenton reaction and myoglobin redox cycle plays crucial role in the pathogenesis of myoglobinuric acute kidney injury (AKI). It may directly damage renal tubules as well as generate lipid peroxidation products with vasoconstrictor properties. N-acetylcysteine (NAC) is an antioxidant that has been proven for the protective effects in many experimental models of renal injury and also the improvement of renal microcirculation. The aim of this study was to scrutinize any possible protective effect of NAC in glycerol induced rat model by examining tubular necrosis and hyaline cast formation, and to explore whether the effect was dose-related or not. Thirty five male Wistar rats were divided into five groups: 1) saline control group, (2) glycerol (50%, 8ml/kg, i.m) plus saline i.v group, 3) glycerol plus NAC (100 mg/kg)-treated group, 4) glycerol plus NAC (200 mg/kg)-treated group, 5) glycerol plus NAC (400 mg/kg)-treated group. Rats were sacrificed at 24 h after glycerol injection, and renal tissues were harvested for making histopathologic slides. Glycerol administration significantly increased renal tubular necrosis and hyaline cast formation, however NAC administration prevented the tubular damage. There were significant differences of necrosis and hyaline cast formation scores between glycerol+NAC treated groups with glycerol alone treated group (p<0.05). However there was a significant correlation between NAC dose with tubular necrosis score (p<0.05), indicating that the dose increment produced less protection from tubular damage. N-acetylcysteine was found to attenuate renal tubular necrosis and hyaline cast formation in this glycerol induced rat model, and the least dose of NAC i.e 100 mg/kg was the recommanded dose.  


Myoglobin; acute kidney injury; N-Acetylcysteine; tubular necrosis; cast formation; gangguan ginjal akut; nekrosis tubulus; pembentukan cast

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