EFFECTIVENESS OF N ACETYLCYSTEINE AND TAURINE IN REDUCING MICROALBUMINURIA IN DIABETIC AND HYPERTENSIVE PATIENTS WITH CHRONIC KIDNEY DISEASE: A RETROSPECTIVE, OBSERVATIONAL STUDY

V. Mohan, V. Ashwin Karuppan, Subir Chandra Swar, Manojit Ketan Mukhopadhyay, Nanditha Arun, Debasis Basu, MC Deepaklal, Yash Patel, Mahendra Yashwant Sawant, Gayatri Veeramani Jayaraman*, Nagashankar N., Monjori Mitra

Background: Microalbuminuria is one of the earliest signs and a major risk factor for chronic kidney disease (CKD) progression, often aggravated by the concomitant presence of diabetes and/or hypertension. One of the major pathophysiological contributors to CKD is oxidative stress. The current study investigated the effectiveness of combination therapy with antioxidants N-acetylcysteine (NAC) and Taurine in reducing urinary albumin to creatinine ratio (uACR). Methods: In this retrospective study, data were analyzed from 305 adult diabetic and/or hypertensive patients diagnosed with CKD stage 1-3. All patients had microalbuminuria (uACR: 30-300mg/g) and were treated with NAC (150mg) + Taurine (500mg) (Nefrosave®) as an adjuvant therapy. The primary and secondary outcome measures included changes in uACR and the incidence of adverse events, respectively, from baseline to Day 90 of treatment. Results: The overall mean uACR reduced significantly from 131.13mg/g to 115.69mg/g (11.77%, p<0.001) after 90 days of treatment with NAC+Taurine. Reduction in mean uACR was also evident in subgroups of patients with both diabetes and hypertension (11.15%, p<0.001), diabetes alone (15.09%, p<0.001), and hypertension alone (8.31%, p=0.561), as well as amongst patients with CKD stage 1 (16.77%, p=0.002), stage 2 (14.45%, p<0.001) and stage 3 (5.19%, p=0.003). No adverse events were reported. Conclusion: The combination of NAC and Taurine could be an effective nephroprotective adjuvant therapy in reducing microalbuminuria in diabetic and/or hypertensive adult patients with CKD stage 1-3; Outcome was found to be better when treatment was initiated early.