N-acetylcysteine may prevent acute kidney injury in high risk patients undergoing off-pump coronary artery bypass graft.

Inclusion Criteria:

• Patients undergoing off-pump coronary artery bypass surgery and meets more than one of the following criteria;

  • preoperative serum creatinine > 1.4 mg/dl
  • Age > 70 years
  • Diabetes mellitus
  • left ventricular ejection fraction < 35 % or congestive heart failure (NYHA III or IV)
  • emergency surgery or re-operation

Exclusion Criteria:

• preoperative acute renal failure, patients on dialysis, use of N-acetylcystein within 5 days of surgery, history of hypersensitivity to N-acetylcystein