Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://cr.elmerpub.com

Original Article

Volume 17, Number 5, October 2026, pages 437-452

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

↓ Figure 1. Median comparison between NAC + taurine plus standard of care versus standard of care alone from baseline to 12 ± 2 weeks for (a) change in uACR (mg/g), (b) change in serum creatinine (mg/dL), and (c) change in eGFR (mL/min/1.73 m²). NAC: N-acetylcysteine; uACR: albumin-to-creatinine ratio; eGFR: estimated glomerular filtration rate.

↓ Figure 2. Median comparison between NAC + taurine plus standard of care versus standard of care alone from baseline to 12 ± 2 weeks stratified by CKD stages for change in uACR (mg/g). NAC: N-acetylcysteine; uACR: albumin-to-creatinine ratio; CKD: chronic kidney disease. Level of significance, *P < 0.05, ***P < 0.001.

↓ Figure 3. Median comparison between NAC + taurine plus standard of care versus standard of care alone from baseline to 12 ± 2 weeks stratified by CKD stages for change in serum creatinine (mg/dL). NAC: N-acetylcysteine; CKD: chronic kidney disease. Level of significance, *P < 0.05, ***P < 0.001.

↓ Figure 4. Median comparison between NAC + taurine plus standard of care versus standard of care alone from baseline to 12 ± 2 weeks stratified by CKD stages for change in eGFR (mL/min/1.73 m²). NAC: N-acetylcysteine; CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate. Level of significance, *P < 0.05, ***P < 0.001.

↓ Figure 5. Proportions of patients with ≥ 30% improvement in uACR and serum creatinine from baseline to 12 ± 2 weeks. uACR: urinary albumin-to-creatinine ratio. Level of significance, *P < 0.05, **P < 0.01.

↓ **Table 1.** Baseline Demographics and Clinical Characteristics
Parameters	NAC + taurine + standard of care	Standard of care	P-value
P < 0.05, P < 0.01, and **P < 0.001. NAC: N-acetylcysteine; SD: standard deviation; CKD: chronic kidney disease; SPO₂: oxygen saturation; NA: not available.
Overall patients, n	300	150	-
Age (years), mean ± SD	59.79 ± 12.30	56.53 ± 13.80	0.017*
Weight (kg), mean ± SD	68.22 ± 9.63	68.77 ± 8.59	0.374
Height (cm), mean ± SD	165.74 ± 7.55	166.01 ± 7.33	0.998
Sex			0.999
Male, n (%)	196 (65.33%)	98 (65.33%)
Female, n (%)	104 (34.67%)	52 (34.67%)
Stage of CKD			0.006**
Stage 1, n (%)	16 (5.33%)	19 (12.67%)
Stage 2, n (%)	61 (20.33%)	33 (22.00%)	0.682
Stage 3, n (%)	223 (74.33%)	98 (65.33%)	0.047*
Systolic blood pressure (SBP) (mm Hg), mean ± SD	137.93 ± 16.53	141.39 ± 12.90	0.010*
Diastolic blood pressure (DBP) (mm Hg), mean ± SD	84.48 ± 7.97	85.85 ± 5.81	0.185
Pulse rate (beats per minute), mean ± SD	78.32 ± 6.50	77.01 ± 5.66	0.042*
SPO₂ (%)			0.07
n	71	30
Mean ± SD	96.31 ± 0.71	96.60 ± 0.89
Temperature (°F)			0.25
n	11	9
Mean ± SD	97.91 ± 0.48	97.70 ± 0.36
Respiratory rate (breaths per minute)			0.301
n	11	11
Mean ± SD	19.82 ± 2.27	20.64 ± 2.50
Duration of CKD (years)			0.999
Number of patients with CKD (%)	300 (100%)	150 (100%)
Mean ± SD	3.11 ± 2.76	1.93 ± 1.31	< 0.001***
Duration of hypertension (years)			0.027*
Number of patients with hypertension (%)	270 (90.00%)	144 (96.00%)	< 0.001***
Mean ± SD	9.56 ± 9.11	7.08 ± 9.46
Duration of type 2 diabetes mellitus (T2DM) (years)
Number of patients with T2DM (%)	188 (62.67%)	57 (38.00%)	< 0.001***
Mean ± SD	9.92 ± 9.10	11.67 ± 11.47	0.944
Both hypertension and type 2 diabetes mellitus, n (%)	158 (52.67%)	51 (34.00%)	< 0.001***
Alcohol status
Non-drinker	259 (86.33%)	130 (86.67%)	0.922
Quit drinking	26 (8.67%)	10 (6.67%)	0.461
Casual drinking	5 (1.67%)	4 (2.67%)	0.619
Occasional drinker	7 (2.33%)	6 (4.00%)	0.320
Social drinker	3 (1.00%)	-	NA
Smoking status
Non-smoker	244 (81.33%)	120 (80.00%)	0.735
Quit smoking	51 (17.00%)	20 (13.33%)	0.315
Casual smoking	1 (0.33%)	1 (0.33%)	0.499
Moderate smoking	1 (0.33%)	2 (1.33%)	0.248
Light smoking	3 (1.00%)	6 (4.00%)	0.243
Chain smoker	-	1 (0.67%)	NA

↓ Table 1. Baseline Demographics and Clinical Characteristics

Parameters

NAC + taurine + standard of care

Standard of care

P-value

*P < 0.05, **P < 0.01, and ***P < 0.001. NAC: N-acetylcysteine; SD: standard deviation; CKD: chronic kidney disease; SPO₂: oxygen saturation; NA: not available.

Overall patients, n

300

150

Age (years), mean ± SD

59.79 ± 12.30

56.53 ± 13.80

0.017*

Weight (kg), mean ± SD

68.22 ± 9.63

68.77 ± 8.59

0.374

Height (cm), mean ± SD

165.74 ± 7.55

166.01 ± 7.33

0.998

Sex

0.999

Male, n (%)

196 (65.33%)

98 (65.33%)

Female, n (%)

104 (34.67%)

52 (34.67%)

Stage of CKD

0.006**

Stage 1, n (%)

16 (5.33%)

19 (12.67%)

Stage 2, n (%)

61 (20.33%)

33 (22.00%)

0.682

Stage 3, n (%)

223 (74.33%)

98 (65.33%)

0.047*

Systolic blood pressure (SBP) (mm Hg), mean ± SD

137.93 ± 16.53

141.39 ± 12.90

0.010*

Diastolic blood pressure (DBP) (mm Hg), mean ± SD

84.48 ± 7.97

85.85 ± 5.81

0.185

Pulse rate (beats per minute), mean ± SD

78.32 ± 6.50

77.01 ± 5.66

0.042*

SPO₂ (%)

0.07

Mean ± SD

96.31 ± 0.71

96.60 ± 0.89

Temperature (°F)

0.25

Mean ± SD

97.91 ± 0.48

97.70 ± 0.36

Respiratory rate (breaths per minute)

0.301

Mean ± SD

19.82 ± 2.27

20.64 ± 2.50

Duration of CKD (years)

0.999

Number of patients with CKD (%)

300 (100%)

150 (100%)

Mean ± SD

3.11 ± 2.76

1.93 ± 1.31

< 0.001***

Duration of hypertension (years)

0.027*

Number of patients with hypertension (%)

270 (90.00%)

144 (96.00%)

< 0.001***

Mean ± SD

9.56 ± 9.11

7.08 ± 9.46

Duration of type 2 diabetes mellitus (T2DM) (years)

Number of patients with T2DM (%)

188 (62.67%)

57 (38.00%)

< 0.001***

Mean ± SD

9.92 ± 9.10

11.67 ± 11.47

0.944

Both hypertension and type 2 diabetes mellitus, n (%)

158 (52.67%)

51 (34.00%)

< 0.001***

Alcohol status

Non-drinker

259 (86.33%)

130 (86.67%)

0.922

Quit drinking

26 (8.67%)

10 (6.67%)

0.461

Casual drinking

5 (1.67%)

4 (2.67%)

0.619

Occasional drinker

7 (2.33%)

6 (4.00%)

0.320

Social drinker

3 (1.00%)

Smoking status

Non-smoker

244 (81.33%)

120 (80.00%)

0.735

Quit smoking

51 (17.00%)

20 (13.33%)

0.315

Casual smoking

1 (0.33%)

0.499

Moderate smoking

1 (0.33%)

2 (1.33%)

0.248

Light smoking

3 (1.00%)

6 (4.00%)

0.243

Chain smoker

1 (0.67%)

↓ **Table 2.** Change in uACR (mg/g) Stratified by CKD Stages From Baseline to 12 ± 2 Weeks of Treatment in the Two Groups
	Baseline	12 ± 2 weeks	Mean difference from baseline to 12 ± 2 weeks, Δ (Δ%) (95% CI), P-value^###	Adjusted mean difference from baseline to 12 ± 2 weeks, δ (95% CI), P-value^#	Median of difference from baseline to 12 ± 2 weeks (95% CI), P-value^##
Statistical tests used: ^#Mann−Whitney U test; ^##Wilcoxon signed-rank test; ^###repeated-measures ANOVA; ***repeated-measures ANCOVA; between-group difference: univariate ANCOVA; level of significance, P < 0.001. uACR: urinary albumin-to-creatinine ratio; CI: confidence interval; NAC: N-acetylcysteine; SD: standard deviation; CKD: chronic kidney disease; Q1, Q3: first and third quartiles; ANOVA: repeated-measures analysis of variance; ANCOVA: repeated-measures analysis of covariance; min, max: minimum, maximum.
Overall
NAC + taurine + standard of care (n = 300)
Mean ± SD, µg/mg	159.87 ± 65.37	146.11 ± 64.89	−13.76 (−8.61%), (−15.27, −12.26), < 0.001***	−13.76 (−15.25, −12.27), < 0.001***	−12.40 (−14.00, −10.80), < 0.001***
Median (min, max)	160.05 (30.00, 298.05)	140.00 (27.00, 295.60)
Q1, Q3	104.00, 203.97	90.62, 199.90
Standard of care (n = 150)			18.68 (11.26%) (16.54, 20.81), < 0.001***	18.67 (16.50, 20.84), < 0.001***	18.10 (16.63, 19.66), < 0.001***
Mean ± SD, µg/mg	165.85 ± 58.71	184.53 ± 58.64
Median (min, max)	178.30 (36.00, 294.56)	199.35 (39.00, 298.10)
Q1, Q3	108.60, 207.59	130.00, 224.71
Between-group difference			−32.44 (−35.05, −29.83), < 0.001***	−33.01 (−35.74, −30.28), < 0.001***	−30.34 (−32.60, −28.00), < 0.001***
Stage 1 CKD
NAC + taurine + standard of care (n = 16)
Mean ± SD, µg/mg	146.16 ± 54.77	117.75 ± 59.70	−28.41 (−19.44%) (−33.71, −23.11), < 0.001***	−24.11 (−33.74, −14.49), < 0.001***	−28.11 (−35.35, −21.89), < 0.001***
Median (min, max)	144.10 (85.00, 284.88)	110.15 (50.10, 280.00)
Q1, Q3	98.50, 179.65	66.28, 150.52
Standard of care (n = 19)			24.85 (19.75%) (19.98, 29.71), < 0.001***	21.23 (12.90, 29.57), < 0.001***	24.31 (20.21, 29.39), < 0.001***
Mean ± SD, µg/mg	125.84 ± 31.58	150.69 ± 33.86
Median (min, max)	121.67 (88.50, 198.54)	140.14 (109.80, 220.36)
Q1, Q3	102.04, 148.30	122.98, 180.10
Between-group difference			−53.26 (−60.45, −46.06), < 0.001***	−45.65 (−62.46, −28.84), < 0.001***	−52.55 (−61.00, −45.20), < 0.001***
Stage 2 CKD
NAC + taurine + standard of care (n = 61)
Mean ± SD, µg/mg	155.61 ± 49.98	131.18 ± 46.86	−24.43 (−15.70%) (−27.99, −20.87), < 0.001***	−25.05 (−28.72, −21.38), < 0.001***	−23.11 (−27.00, −19.69), < 0.001***
Median (min, max)	156.87 (44.00, 280.10)	124.00 (30.00, 250.16)
Q1, Q3	114.65, 185.56	94.47, 154.35
Standard of care (n = 33)			19.91 (10.77%) (15.07, 24.75), < 0.001***	21.05 (15.76, 26.35), < 0.001***	19.41 (15.22, 23.29), < 0.001***
Mean ± SD, µg/mg	184.89 ± 59.13	204.80 ± 57.25
Median (min, max)	191.28 (94.60, 288.30)	210.40 (120.00, 298.00)
Q1, Q3	120.00, 222.36	130.50, 245.55
Between-group difference			−44.34 (−50.36, −38.34), < 0.001***	−48.46 (−55.70, −41.22), < 0.001***	−42.28 (−48.46, −37.00), < 0.001***
Stage 3 CKD
NAC + taurine + standard of care (n = 223)
Mean ± SD, µg/mg	162.02 ± 69.68	152.22 ± 68.42	−9.80 (−6.05%) (−11.32, −8.27), < 0.001***	−9.42 (−10.93, −7.90), < 0.001***	−8.78 (−10.17, −7.52), < 0.001***
Median (min, max)	166.10 (30.00, 298.05)	150.00 (27.00, 295.60)
Q1, Q3	104.00, 208.90	96.00, 202.20
Standard of care (n = 98)			17.06 (10.20%) (14.77, 19.36), < 0.001***	16.21 (13.87, 18.55), < 0.001***	16.52 (15.00, 18.26), < 0.001***
Mean ± SD, µg/mg	167.20 ± 59.31	184.26 ± 60.20
Median (min, max)	186.78 (36.00, 294.56)	200.10 (39.00, 298.10)
Q1, Q3	107.00, 208.09	121.15, 226.62
Between-group difference			−26.86 (−29.62, −24.10), < 0.001***	−26.08 (−28.97, −23.18), < 0.001***	−25.22 (−27.58, −23.04), < 0.001***

↓ Table 2. Change in uACR (mg/g) Stratified by CKD Stages From Baseline to 12 ± 2 Weeks of Treatment in the Two Groups

Baseline

12 ± 2 weeks

Mean difference from baseline to 12 ± 2 weeks, Δ (Δ%) (95% CI), P-value^###

Adjusted mean difference from baseline to 12 ± 2 weeks, δ (95% CI), P-value^#

Median of difference from baseline to 12 ± 2 weeks (95% CI), P-value^##

Statistical tests used: ^#Mann−Whitney U test; ^##Wilcoxon signed-rank test; ^###repeated-measures ANOVA; ***repeated-measures ANCOVA; between-group difference: univariate ANCOVA; level of significance, P < 0.001. uACR: urinary albumin-to-creatinine ratio; CI: confidence interval; NAC: N-acetylcysteine; SD: standard deviation; CKD: chronic kidney disease; Q1, Q3: first and third quartiles; ANOVA: repeated-measures analysis of variance; ANCOVA: repeated-measures analysis of covariance; min, max: minimum, maximum.

Overall

NAC + taurine + standard of care (n = 300)

Mean ± SD, µg/mg

159.87 ± 65.37

146.11 ± 64.89

−13.76 (−8.61%),
(−15.27, −12.26),
< 0.001***

−13.76 (−15.25, −12.27),
< 0.001***

−12.40 (−14.00, −10.80),
< 0.001***

Median (min, max)

160.05 (30.00, 298.05)

140.00 (27.00, 295.60)

Q1, Q3

104.00, 203.97

90.62, 199.90

Standard of care (n = 150)

18.68 (11.26%)
(16.54, 20.81),
< 0.001***

18.67 (16.50, 20.84),
< 0.001***

18.10 (16.63, 19.66),
< 0.001***

Mean ± SD, µg/mg

165.85 ± 58.71

184.53 ± 58.64

Median (min, max)

178.30 (36.00, 294.56)

199.35 (39.00, 298.10)

Q1, Q3

108.60, 207.59

130.00, 224.71

Between-group difference

−32.44 (−35.05, −29.83),
< 0.001***

−33.01 (−35.74, −30.28),
< 0.001***

−30.34 (−32.60, −28.00),
< 0.001***

Stage 1 CKD

NAC + taurine + standard of care (n = 16)

Mean ± SD, µg/mg

146.16 ± 54.77

117.75 ± 59.70

−28.41 (−19.44%)
(−33.71, −23.11),
< 0.001***

−24.11 (−33.74, −14.49),
< 0.001***

−28.11 (−35.35, −21.89),
< 0.001***

Median (min, max)

144.10 (85.00, 284.88)

110.15 (50.10, 280.00)

Q1, Q3

98.50, 179.65

66.28, 150.52

Standard of care (n = 19)

24.85 (19.75%)
(19.98, 29.71),
< 0.001***

21.23 (12.90, 29.57),
< 0.001***

24.31 (20.21, 29.39),
< 0.001***

Mean ± SD, µg/mg

125.84 ± 31.58

150.69 ± 33.86

Median (min, max)

121.67 (88.50, 198.54)

140.14 (109.80, 220.36)

Q1, Q3

102.04, 148.30

122.98, 180.10

Between-group difference

−53.26 (−60.45, −46.06),
< 0.001***

−45.65 (−62.46, −28.84),
< 0.001***

−52.55 (−61.00, −45.20),
< 0.001***

Stage 2 CKD

NAC + taurine + standard of care (n = 61)

Mean ± SD, µg/mg

155.61 ± 49.98

131.18 ± 46.86

−24.43 (−15.70%)
(−27.99, −20.87),
< 0.001***

−25.05 (−28.72, −21.38),
< 0.001***

−23.11 (−27.00, −19.69),
< 0.001***

Median (min, max)

156.87 (44.00, 280.10)

124.00 (30.00, 250.16)

Q1, Q3

114.65, 185.56

94.47, 154.35

Standard of care (n = 33)

19.91 (10.77%)
(15.07, 24.75),
< 0.001***

21.05 (15.76, 26.35),
< 0.001***

19.41 (15.22, 23.29),
< 0.001***

Mean ± SD, µg/mg

184.89 ± 59.13

204.80 ± 57.25

Median (min, max)

191.28 (94.60, 288.30)

210.40 (120.00, 298.00)

Q1, Q3

120.00, 222.36

130.50, 245.55

Between-group difference

−44.34 (−50.36, −38.34),
< 0.001***

−48.46 (−55.70, −41.22),
< 0.001***

−42.28 (−48.46, −37.00),
< 0.001***

Stage 3 CKD

NAC + taurine + standard of care (n = 223)

Mean ± SD, µg/mg

162.02 ± 69.68

152.22 ± 68.42

−9.80 (−6.05%)
(−11.32, −8.27),
< 0.001***

−9.42 (−10.93, −7.90),
< 0.001***

−8.78 (−10.17, −7.52),
< 0.001***

Median (min, max)

166.10 (30.00, 298.05)

150.00 (27.00, 295.60)

Q1, Q3

104.00, 208.90

96.00, 202.20

Standard of care (n = 98)

17.06 (10.20%)
(14.77, 19.36),
< 0.001***

16.21 (13.87, 18.55),
< 0.001***

16.52 (15.00, 18.26),
< 0.001***

Mean ± SD, µg/mg

167.20 ± 59.31

184.26 ± 60.20

Median (min, max)

186.78 (36.00, 294.56)

200.10 (39.00, 298.10)

Q1, Q3

107.00, 208.09

121.15, 226.62

Between-group difference

−26.86 (−29.62, −24.10),
< 0.001***

−26.08 (−28.97, −23.18),
< 0.001***

−25.22 (−27.58, −23.04),
< 0.001***

↓ **Table 3.** Change in Serum Creatinine (mg/dL) Stratified by CKD Stages From Baseline to 12 ± 2 Weeks of Treatment in the Two Groups
	Baseline	12 ± 2 weeks	Median of difference from baseline to 12 ± 2 weeks (95% CI), P-value^##	Median of difference between groups (95% CI), P-value^#
Statistical tests used: ^#Mann–Whitney U test; ^##Wilcoxon signed-rank test; level of significance, ***P < 0.001. CI: confidence interval; NAC: N-acetylcysteine; SD: standard deviation; CKD: chronic kidney disease; Q1, Q3: first and third quartiles; min, max: minimum, maximum.
Overall
NAC + taurine + standard of care (n = 300)			−0.05 (−0.06, −0.05), < 0.001***	−0.20 (−0.20, −0.20), < 0.001***
Mean ± SD, mg/dL	1.54 ± 0.38	1.46 ± 0.43
Median (min, max)	1.54 (0.56, 2.44)	1.50 (0.30, 2.40)
Q1, Q3	1.30, 1.80	1.20, 1.70
Standard of care (n = 150)			0.15 (0.11, 0.15), < 0.001***
Mean ± SD, mg/dL	1.47 ± 0.37	1.60 ± 0.35
Median (min, max)	1.40 (0.80, 2.40)	1.60 (0.80, 2.40)
Q1, Q3	1.20, 1.73	1.40, 1.90
Stage 1 CKD
NAC + taurine + standard of care (n = 16)			−0.20 (−0.29, −0.09), 0.001**	−0.36 (−0.48, −0.26), < 0.001***
Mean ± SD, mg/dL	0.85 ± 0.12	0.66 ± 0.19
Median (min, max)	0.90 (0.56, 1.00)	0.69 (0.40, 1.00)
Q1, Q3	0.80, 0.91	0.50, 0.82
Standard of care (n = 19)			2.00 (0.15, 2.50), < 0.001***
Mean ± SD, mg/dL	1.01 ± 0.11	1.19 ± 0.16
Median (min, max)	1.10 (0.80, 1.10)	1.20 (0.80, 1.40)
Q1, Q3	0.90, 1.10	1.10, 1.30
Stage 2 CKD
NAC + taurine + standard of care (n = 61)	−0.13 (−0.18, −0.10), < 0.001***	−0.30 (−0.35, −0.21), < 0.001***
Mean ± SD, mg/dL	1.16 ± 0.21	1.00 ± 0.28
Median (min, max)	1.20 (0.80, 1.60)	1.00 (0.30, 1.50)
Q1, Q3	0.98, 1.31	0.80, 1.20
Standard of care (n = 33)			0.15 (0.12, 0.20), < 0.001***
Mean ± SD, mg/dL	1.16 ± 0.16	1.33 ± 0.20
Median (min, max)	1.20 (0.80, 1.40)	1.40 (1.00, 1.70)
Q1, Q3	1.10, 1.30	1.10, 1.50
Stage 3 CKD
NAC + taurine + standard of care (n = 223)			−0.05 (−0.05, −0.03), < 0.001***	−0.17 (−0.20, −0.13), < 0.001***
Mean ± SD, mg/dL	1.69 ± 0.29	1.65 ± 0.30
Median (min, max)	1.70 (1.08, 2.44)	1.60 (1.00, 2.40)
Q1, Q3	1.50, 1.89	1.40, 1.80
Standard of care (n = 98)			0.11 (0.10, 0.14), < 0.001***
Mean ± SD, mg/dL	1.66 ± 0.30	1.78 ± 0.28
Median (min, max)	1.60 (1.10, 2.40)	1.80 (1.10, 2.40)
Q1, Q3	1.40, 1.89	1.58, 2.00

↓ Table 3. Change in Serum Creatinine (mg/dL) Stratified by CKD Stages From Baseline to 12 ± 2 Weeks of Treatment in the Two Groups

Baseline

12 ± 2 weeks

Median of difference from baseline to 12 ± 2 weeks (95% CI), P-value^##

Median of difference between groups (95% CI), P-value^#

Statistical tests used: ^#Mann–Whitney U test; ^##Wilcoxon signed-rank test; level of significance, ***P < 0.001. CI: confidence interval; NAC: N-acetylcysteine; SD: standard deviation; CKD: chronic kidney disease; Q1, Q3: first and third quartiles; min, max: minimum, maximum.

Overall

NAC + taurine + standard of care (n = 300)

−0.05 (−0.06, −0.05),
< 0.001***

−0.20 (−0.20, −0.20),
< 0.001***

Mean ± SD, mg/dL

1.54 ± 0.38

1.46 ± 0.43

Median (min, max)

1.54 (0.56, 2.44)

1.50 (0.30, 2.40)

Q1, Q3

1.30, 1.80

1.20, 1.70

Standard of care (n = 150)

0.15 (0.11, 0.15),
< 0.001***

Mean ± SD, mg/dL

1.47 ± 0.37

1.60 ± 0.35

Median (min, max)

1.40 (0.80, 2.40)

1.60 (0.80, 2.40)

Q1, Q3

1.20, 1.73

1.40, 1.90

Stage 1 CKD

NAC + taurine + standard of care (n = 16)

−0.20 (−0.29, −0.09),
0.001**

−0.36 (−0.48, −0.26),
< 0.001***

Mean ± SD, mg/dL

0.85 ± 0.12

0.66 ± 0.19

Median (min, max)

0.90 (0.56, 1.00)

0.69 (0.40, 1.00)

Q1, Q3

0.80, 0.91

0.50, 0.82

Standard of care (n = 19)

2.00 (0.15, 2.50),
< 0.001***

Mean ± SD, mg/dL

1.01 ± 0.11

1.19 ± 0.16

Median (min, max)

1.10 (0.80, 1.10)

1.20 (0.80, 1.40)

Q1, Q3

0.90, 1.10

1.10, 1.30

Stage 2 CKD

NAC + taurine + standard of care (n = 61)

−0.13 (−0.18, −0.10),
< 0.001***

−0.30 (−0.35, −0.21),
< 0.001***

Mean ± SD, mg/dL

1.16 ± 0.21

1.00 ± 0.28

Median (min, max)

1.20 (0.80, 1.60)

1.00 (0.30, 1.50)

Q1, Q3

0.98, 1.31

0.80, 1.20

Standard of care (n = 33)

0.15 (0.12, 0.20),
< 0.001***

Mean ± SD, mg/dL

1.16 ± 0.16

1.33 ± 0.20

Median (min, max)

1.20 (0.80, 1.40)

1.40 (1.00, 1.70)

Q1, Q3

1.10, 1.30

1.10, 1.50

Stage 3 CKD

NAC + taurine + standard of care (n = 223)

−0.05 (−0.05, −0.03),
< 0.001***

−0.17 (−0.20, −0.13),
< 0.001***

Mean ± SD, mg/dL

1.69 ± 0.29

1.65 ± 0.30

Median (min, max)

1.70 (1.08, 2.44)

1.60 (1.00, 2.40)

Q1, Q3

1.50, 1.89

1.40, 1.80

Standard of care (n = 98)

0.11 (0.10, 0.14),
< 0.001***

Mean ± SD, mg/dL

1.66 ± 0.30

1.78 ± 0.28

Median (min, max)

1.60 (1.10, 2.40)

1.80 (1.10, 2.40)

Q1, Q3

1.40, 1.89

1.58, 2.00

↓ **Table 4.** Change in eGFR (mL/min/1.73 m²) Stratified by CKD Stages From Baseline to 12 ± 2 Weeks of Treatment in the Two Groups
	Baseline	12 ± 2 weeks	Median of difference from baseline to 12 ± 2 weeks (95% CI), P-value^##	Median of difference between groups (95% CI), P-value^#
Statistical tests used: ^#Mann–Whitney U test; ^##Wilcoxon signed-rank test; level of significance, ***P < 0.001. eGFR: estimated glomerular filtration rate; CI: confidence interval; NAC: N-acetylcysteine; SD: standard deviation; CKD: chronic kidney disease; Q1, Q3: first and third quartiles; min, max: minimum, maximum.
Overall
NAC + taurine + standard of care (n = 300)			2.06 (1.60, 2.71), < 0.001***	7.51 (6.52, 8.92), < 0.001***
Mean ± SD, mL/min/1.73 m²	50.62 ± 17.19	54.97 ± 22.42
Median (min, max)	46.00 (30.00, 106.00)	47.59 (30.13, 130.60)
Q1, Q3	38.00, 60.75	40.03, 62.95
Standard of care (n = 150)			−5.47 (−6.75, −4.54), < 0.001***
Mean ± SD, mL/min/1.73 m²	55.30 ± 19.18	48.62 ± 15.24
Median (min, max)	49.00 (30.00, 99.00)	44.24 (28.39, 93.19)
Q1, Q3	41.00, 68.00	36.96, 57.95
Stage 1 CKD
NAC + taurine + standard of care (n = 16)			10.05 (3.97, 17.20), < 0.001***	25.97 (19.89, 33.65), < 0.001***
Mean ± SD, mL/min/1.73 m²	97.00 ± 4.62	108.07 ± 11.81
Median (min, max)	96.00 (91.00, 106.00)	107.12 (93.68, 130.60)
Q1, Q3	92.50, 101.25	96.13, 117.04
Standard of care (n = 19)
Mean ± SD, mL/min/1.73 m²	93.00 ± 2.38	76.92 ± 8.02	−17.40 (−20.56, −11.73), < 0.001***
Median (min, max)	93.00 (90.00, 99.00)	74.39 (66.53, 93.19)
Q1, Q3	91.00, 95.00	70.63, 84.05
Stage 2 CKD
NAC + taurine + standard of care (n = 61)			9.96 (7.33, 13.44), < 0.001***	19.67 (16.00, 24.20), < 0.001***
Mean ± SD, mL/min/1.73 m²	69.34 ± 7.87	81.56 ± 16.79
Median (min, max)	66.00 (60.00, 86.00)	77.43 (58.37, 128.35)
Q1, Q3	62.00, 76.50	67.37, 92.98
Standard of care (n = 33)			−10.22 (−12.70, −7.76), < 0.001***
Mean ± SD, mL/min/1.73 m²	68.94 ± 6.34	58.71 ± 8.39
Median (min, max)	69.00 (61.00, 86.00)	58.24 (44.38, 83.84)
Q1, Q3	64.00, 71.50	53.18, 62.32
Stage 3 CKD
NAC + taurine + standard of care (n = 223)			1.26 (0.98, 1.51), < 0.001***	11.39 (9.58, 12.79), < 0.001***
Mean ± SD, mL/min/1.73 m²	42.17 ± 7.54	43.89 ± 8.40
Median (min, max)	42.00 (30.00, 59.00)	42.83 (30.13, 70.87)
Q1, Q3	36.00, 48.00	37.15, 49.77
Standard of care (n = 98)			−3.47 (−4.07, −2.95), < 0.001***
Mean ± SD, mL/min/1.73 m²	43.40 ± 8.14	39.73 ± 7.08
Median (min, max)	43.00 (30.00, 59.00)	38.67 (28.39, 57.88)
Q1, Q3	37.00, 49.00	34.90, 44.08

↓ Table 4. Change in eGFR (mL/min/1.73 m²) Stratified by CKD Stages From Baseline to 12 ± 2 Weeks of Treatment in the Two Groups

Baseline

12 ± 2 weeks

Median of difference from baseline to 12 ± 2 weeks (95% CI), P-value^##

Median of difference between groups (95% CI), P-value^#

Statistical tests used: ^#Mann–Whitney U test; ^##Wilcoxon signed-rank test; level of significance, ***P < 0.001. eGFR: estimated glomerular filtration rate; CI: confidence interval; NAC: N-acetylcysteine; SD: standard deviation; CKD: chronic kidney disease; Q1, Q3: first and third quartiles; min, max: minimum, maximum.

Overall

NAC + taurine + standard of care (n = 300)

2.06 (1.60, 2.71),
< 0.001***

7.51 (6.52, 8.92),
< 0.001***

Mean ± SD, mL/min/1.73 m²

50.62 ± 17.19

54.97 ± 22.42

Median (min, max)

46.00 (30.00, 106.00)

47.59 (30.13, 130.60)

Q1, Q3

38.00, 60.75

40.03, 62.95

Standard of care (n = 150)

−5.47 (−6.75, −4.54),
< 0.001***

Mean ± SD, mL/min/1.73 m²

55.30 ± 19.18

48.62 ± 15.24

Median (min, max)

49.00 (30.00, 99.00)

44.24 (28.39, 93.19)

Q1, Q3

41.00, 68.00

36.96, 57.95

Stage 1 CKD

NAC + taurine + standard of care (n = 16)

10.05 (3.97, 17.20),
< 0.001***

25.97 (19.89, 33.65),
< 0.001***

Mean ± SD, mL/min/1.73 m²

97.00 ± 4.62

108.07 ± 11.81

Median (min, max)

96.00 (91.00, 106.00)

107.12 (93.68, 130.60)

Q1, Q3

92.50, 101.25

96.13, 117.04

Standard of care (n = 19)

Mean ± SD, mL/min/1.73 m²

93.00 ± 2.38

76.92 ± 8.02

−17.40 (−20.56, −11.73),
< 0.001***

Median (min, max)

93.00 (90.00, 99.00)

74.39 (66.53, 93.19)

Q1, Q3

91.00, 95.00

70.63, 84.05

Stage 2 CKD

NAC + taurine + standard of care (n = 61)

9.96 (7.33, 13.44),
< 0.001***

19.67 (16.00, 24.20),
< 0.001***

Mean ± SD, mL/min/1.73 m²

69.34 ± 7.87

81.56 ± 16.79

Median (min, max)

66.00 (60.00, 86.00)

77.43 (58.37, 128.35)

Q1, Q3

62.00, 76.50

67.37, 92.98

Standard of care (n = 33)

−10.22 (−12.70, −7.76),
< 0.001***

Mean ± SD, mL/min/1.73 m²

68.94 ± 6.34

58.71 ± 8.39

Median (min, max)

69.00 (61.00, 86.00)

58.24 (44.38, 83.84)

Q1, Q3

64.00, 71.50

53.18, 62.32

Stage 3 CKD

NAC + taurine + standard of care (n = 223)

1.26 (0.98, 1.51),
< 0.001***

11.39 (9.58, 12.79),
< 0.001***

Mean ± SD, mL/min/1.73 m²

42.17 ± 7.54

43.89 ± 8.40

Median (min, max)

42.00 (30.00, 59.00)

42.83 (30.13, 70.87)

Q1, Q3

36.00, 48.00

37.15, 49.77

Standard of care (n = 98)

−3.47 (−4.07, −2.95),
< 0.001***

Mean ± SD, mL/min/1.73 m²

43.40 ± 8.14

39.73 ± 7.08

Median (min, max)

43.00 (30.00, 59.00)

38.67 (28.39, 57.88)

Q1, Q3

37.00, 49.00

34.90, 44.08