Studying the effect of NAC on the course of treatment of acute pyelonephritis in children

Background and Objective: Acute pyelonephritis is one of the most common urinary tract infections in children, which can lead to serious complications such as renal scarring. This study aimed to investigate the effect of N-acetylcysteine (NAC) as a potent antioxidant on clinical and laboratory parameters in children with acute pyelonephritis. Materials and Methods: This retrospective, observational study was conducted on ۱۶۰ children hospitalized at Hazrat Masoumeh Hospital between ۲۰۱۹ and ۲۰۲۱. Patients were divided into two groups: those who received NAC (۲۰–۳۰ mg/kg/day) and those who did not. Demographic characteristics, clinical symptoms, laboratory findings (such as fever, CRP, and leukocytosis), length of hospital stay, and recovery rates were evaluated. Statistical analysis was performed using appropriate software with a significance level of ۰.۰۵. Results: The results showed no significant differences between the two groups in terms of age (p=۰.۲۴۱) and gender (p=۰.۴۶۱). In the NAC group, the prevalence of fever (p=۰.۰۲) and abnormal CRP levels (p=۰.۰۳۱) were significantly lower. Additionally, the length of hospital stay was significantly shorter in the NAC group (p=۰.۰۰۱). However, there was no significant difference in clinical recovery rates between the two groups (p=۰.۴۶۱). Other clinical symptoms, such as chills, nausea, abdominal pain, flank pain, urinary incontinence, dysuria, and leukocytosis, showed no significant differences (p>۰.۰۵). Conclusion: NAC may reduce the length of hospital stay in children with acute pyelonephritis, but its impact on complete clinical recovery remains unclear. The reduction in fever and abnormal CRP levels in the NAC group indicates its potential anti-inflammatory effects. However, NAC alone may not be sufficient for the complete treatment of pyelonephritis and may need to be combined with other therapies. Further studies with more robust designs and larger sample sizes are necessary to confirm these findings and explore the precise mechanisms of NAC's effects.

کلیدواژه ها:

N-acetylcysteine (NAC) ، acute pyelonephritis ، children ، inflammation ، oxidative stress ، clinical recovery.