Q: Acetylcysteine given during acetaminophen toxicity to protect the liver - also has a protective effect on the kidney?
About half of patients with acetaminophen-induced liver failure may also develop some degree of acute kidney injury (AKI). Patient may develop proteinuria and/or hematuria. This injury occurs via two mechanisms - direct effect with acute tubular necrosis and ischemia due to vascular endothelial damage.
AKI is usually reversible. Unfortunately, despite a robust protective effect on the liver, acetylcysteine has no renal protective effect.
1. Mazer M, Perrone J. Acetaminophen-induced nephrotoxicity: pathophysiology, clinical manifestations, and management. J Med Toxicol 2008; 4:2.
2. Blakely P, McDonald BR. Acute renal failure due to acetaminophen ingestion: a case report and review of the literature. J Am Soc Nephrol 1995; 6:48.