Comparative Study to Evaluate the Effect of Low-Protein Diet Supplementation with Taurine and N-Acetylcysteine, N-Acetylcysteine and Pyridoxamine Dihydrochloride in Preventing the Progression of Chronic Renal Failure in Patients with Non-Diabetic Kidney Disease

Background: Chronic Kidney Disease(CKD) has multifactorial etiology and there are lots of grey zone in understanding its complex pathophysiology. There is no silver bullet for optimal care of CKD. Oxidative stress being well understood and considered as an important common progressive factor for CKD of different etiology. Several research studies focused on reducing oxidative stress and have shown diverse outcomes. In this randomized, open-label, three arms, controlled, single- center study we evaluated the role of N acetylcysteine which is a direct scavenger of free radical, in combination with taurine and pyridoxamine in retarding the progression of non-diabetic kidney disease. Methods: 69 non-dialysis, non-diabetic patients diagnosed with chronic renal failure with GFR more than 15 ml/min/1.73m2 and less than 60ml/min/1.73m2 receiving standard of care were enrolled in the study, of which 22 were in the placebo arm, 23 treated with NT (500 mg Taurine + 150 mg NAC) arm and 24 in the NP (300mg NAC+ 50mg pyridoxamine di-hydrochloride) arm. The subjects in the treatment arm received the study drug twice a day along with low protein (0.6gm protein per Kg body weight) isocaloric diet with 25-30 Kcal/Kg/D and were evaluated monthly up to 6 months. Change in eGFR accorss 3 groups over 6 months were compared.

Heart failure and acquired immune deficiency syndrome: report of 2 cases.

Acquired immune deficiency syndrome (AIDS) patients usually present with prolonged fever, chronic diarrhoea, weight loss and other opportunistic infections. Congestive heart failure is not a usual presentation of AIDS. Here two cases, one a female of 38 years and another a male of 22 years presented with fever and breathlessness. On examination they were found to have features of congestive heart failure. Echocardiography revealed dilated cardiomyopathy. Laboratory investigations suggested human immunodeficiency virus was reactive in both cases with immune deficiencies of different degrees. The first patient expired during hospital stay, but the second one is progressing well with antiretroviral therapy.