Clinical Trial Finds NAC May Help Cats with CKD

Lisa Selvaggio
by Lisa Selvaggio

Chronic kidney disease (CKD) in cats is progressive and can be difficult to manage, so experts have been searching for solutions for a long time. A recent study found that N-Acetylcysteine (NAC) might help bring elevated kidney values down, providing some hope that there’s a new way to support these pets.

Vera Aksionava/Shutterstock

The Aim of the Study


According to the authors of the study, there isn’t a lot of information available about the effects that NAC can have on cats with CKD, but they do know that oxidative stress is a contributing factor to the disease. So, they wanted to perform a study that would allow them to see whether NAC, which has antioxidant and anti-inflammatory properties, would help in the treatment of acute on chronic kidney disease, when there are spikes in kidney function biomarkers.


The study would focus on cats with naturally developing chronic kidney disease, and the experts would incorporate NAC into the typical intravenous fluid therapy that would be used during acute exacerbations of the disease. By comparing the test results of cats who received IV fluids plus NAC versus those that only received IV fluids, they’d be able to determine if the NAC was useful.


The Findings


The study involved 50 cats who were client-owned and previously diagnosed with IRIS stage 2 to 4 CKD. In addition to having azotemic CKD, the cats also showed decreased renal mass bilaterally, changes in renal cortical echogenicity, and rough surface contours of the kidneys on ultrasound. These cats underwent a clinical exam, abdominal ultrasound, blood tests, urinalysis, and urine culture.


The researchers randomly divided the cats into groups. One group was given NAC in a saline solution intravenously, while the placebo group only got a saline solution intravenously, and all of the cats in both groups got fluid therapy with Ringer’s solution. The treatments were given twice a day for seven days.


On the eighth day of the study, urinalysis and blood tests were performed again to see how the treatments affected the cats. They discovered that the NAC helped and didn’t cause any adverse effects.


BUN and UPC went down significantly in the group treated with NAC, while there weren’t any changes in the placebo group.


Both groups of cats experienced a decrease in creatinine and SDMA; however, the cats who received the NAC had significantly lower concentrations.


  • Creatinine in the NAC group was 4.01 ± 0.25 mg/dl. It was 6.44 ± 0.9 mg/dl in the placebo group.
  • SDMA was 16.5 ± 1.21 µg/dl in the NAC group compared to 27 ± 3.89 µg/dl in the placebo group.


The team concluded that incorporating NAC into CKD treatments may potentially help cats who are experiencing acute on chronic kidney disease. This is good news because it might give veterinarians another option when treating this condition.


Join the PetGuide community. Get the latest pet news and product recommendations by subscribing to our newsletter here.

Lisa Selvaggio
Lisa Selvaggio

Lisa Selvaggio is a freelance writer and editor, and our resident cats-pert, with certifications in pet nutrition and pet first aid. She enjoys producing content that helps people understand animals better so they can give their pets a safe and happy home.

More by Lisa Selvaggio

Next