Effect of N-acetylcysteine on inflammation biomarkers in pediatric acute pyelonephritis: a randomized controlled trial

Iran J Kidney Dis. 2015 Nov;9(6):454-62.


Introduction: This study was designed to investigate the effect of N-acetylcysteine (NAC), as a potent and safe antioxidant, on inflammatory biomarkers of acute pyelonephritis in pediatric patients.

Materials and methods: Children (< 15 years old) admitted with a diagnosis of pyelonephritis were recruited in a randomized placebo-controlled trial. They were randomly allocated to 2 groups and recieved placebo or NAC effervescent tablets with daily dose based on their weight, for 5 days. The children were evaluated for serum procalcitonin level, leukocyte count, C-reactive protein (CRP), serum creatinine, and clinical symptoms on the 1st and the 5th days.

Results: Seventy patients, 35 in each group, with a mean age of 5.54 ± 3.10 years completed the study. There was no significant difference between the two groups in the amount of changes in procalcitonin levels after 5 days (P = .90). Within-group analysis confirmed CRP reduction in both groups (P < .001); however, between-group analysis did not show significant difference in CRP reductions, either (P = .65). No significant differences were found between the two groups in the day of resolving pyuria (P = .46), day of resolving bacteriuria (P = .81), or reductions in leukocyte count (P = .64) and neutrophil count (P = .49).

Conclusions: A short period of NAC administration with the recommended doses could not lead to a significant decrease in inflammation biomarkers. Studies on higher doses and longer duration of NAC administration along with evaluation of the long-term effects of the intervention by tools such as renal scntigraphy are suggested.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acetylcysteine / therapeutic use*
  • Acute Disease
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • Calcitonin / blood
  • Calcitonin Gene-Related Peptide
  • Child
  • Child, Preschool
  • Creatinine / blood
  • Double-Blind Method
  • Female
  • Free Radical Scavengers / therapeutic use*
  • Humans
  • Inflammation / blood
  • Leukocyte Count
  • Male
  • Protein Precursors / blood
  • Pyelonephritis / blood*
  • Pyelonephritis / complications
  • Pyelonephritis / drug therapy*


  • Biomarkers
  • CALCA protein, human
  • Free Radical Scavengers
  • Protein Precursors
  • Calcitonin
  • C-Reactive Protein
  • Creatinine
  • Calcitonin Gene-Related Peptide
  • Acetylcysteine