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N-Acetylcysteine Use for Amelioration of Aminoglycoside-Induced Ototoxicity in Dialysis Patients


  • A personal note of the corresponding author: The author, Joshua Weissgarten, an outstanding personality, clinical nephrologist, investigator, educator and medical director, passed away on June 3, 2012 at the age of 63, shortly after acceptance of this manuscript.

Address correspondence to: Leonid Feldman, MD, Nephrology Division, Assaf Harofeh Medical Center, Zerifin 70300, Israel, Tel.: +972-8-9779383, Fax: +972-8-9779705, or e-mail:


Use of aminoglycoside antibiotics is associated with significant ototoxicity, especially on patients with decreased renal function. The risk of aminoglycoside ototoxicity may approach 60%. Oxidative stress has been suggested as a general mechanism of aminoglycoside ototoxicity and is prevalent in dialysis population. N-acetylcysteine (NAC) is an effective antioxidant and has been safely used in dialysis patients. New experimental and clinical data, explored in this review, provide a good case to recommend NAC administration to all dialysis patients, receiving aminoglycosides.