Dual Antioxidant Supplementation With N-Acetylcysteine and Taurine (Nefrosave ® ) for Cardio-Renal Protection in Chronic Kidney Disease Patients With Diabetes and/or Hypertension: A Real-World, Retrospective, Comparative Study

Background: Chronic kidney disease (CKD) is a growing global health burden. Type 2 diabetes mellitus (T2DM) and hypertension are predominant etiological factors. Oxidative stress plays a pivotal role, making antioxidant therapies promising. This study evaluated the effectiveness and tolerability of the antioxidant-combination N-acetylcysteine (NAC; 150 mg) and taurine 500 mg (Nefrosave®) in patients with CKD having T2DM and/or hypertension. Methods: This real-world, retrospective, multicentric study compared electronic medical records (EMRs) of adults with stages 1–3 CKD treated for 12 ± 2 weeks with NAC + taurine plus standard of care (n = 300; test) or standard of care alone (n = 150; control). Endpoints included changes in urinary albumin-to-creatinine ratio (uACR) and serum creatinine (primary), and changes in estimated glomerular filtration rate (eGFR) and adverse events (AEs, secondary). Results: Mean uACR reduced significantly in the test group (−8.61%; P < 0.001), but increased significantly in the control (+11.26%; P < 0.001). A similar trend was observed for changes in median serum creatinine (−0.05 mg/dL, P < 0.001 vs. +0.15 mg/dL, P < 0.001). eGFR improved in the NAC+Taurine group, concomitant with a significant between-group difference of +6 mL/min/1.73 m2 (P < 0.001). Nephroprotective effects were consistent and favorable across CKD stages. A comparatively higher proportion of patients in the test group achieved ≥ 30% improvement in uACR and serum creatinine, although absolute proportions were low. AEs were infrequent and mild; no serious events occurred. Conclusion: NAC + taurine plus standard of care was more effective than standard of care alone in reducing uACR and improving eGFR. Tolerability was good with minimal AEs, supporting the NAC + taurine combination as a potent nephroprotective therapy in CKD patients having T2DM and/or hypertension.