title: Effects of oral adsorbent AST-120 on the progression of chronic renal failure: a randomized controlled study.
abstract: This prospective, randomized controlled study was designed to examine the effects of oral adsorbent AST-120 on the progression of chronic renal failure (CRF) in patients on a strict low protein diet (LPD). Twenty-six patients with CRF (serum creatinine 3.0 to 8.6 mg/dl) on a LPD were randomly assigned to a control group (N = 13) or an AST-120 group (N = 13). The 1/Cr slope and creatinine clearance (CCr) slope were used to estimate the progression rate of CRF; uremic toxins, serum and urinary indoxyl sulfate (IS), peak 2a and guanidino substrates (GS) measured by HPLC. Comparisons were made between the baseline observation period for 6 to 12 months and the treatment period (0.6 g/kg/day of LPD alone or concurrent with 6 g/day of AST-120, for the control and the AST-120 groups, respectively) for 12 to 24 months in both groups. Both the 1/Cr slope and CCr slope were significantly lessened in the treatment period only in the AST-120 group. Serum and urinary IS, but neither peak 2a nor GS were significantly decreased in the treatment period only in the AST-120 group. We conclude that AST-120 administration concurrent with LPD may be superior to LPD alone in retarding the progression of CRF by inhibiting accumulation of indoxyl sulfate.
authors.affiliation: Department of Internal Medicine, Toride Kyodo General Hospital, Ibaraki, Japan.
authors.forename: A
authors.initials: A
authors.lastname: Owada
authors.forename: M
authors.initials: M
authors.lastname: Nakao
authors.forename: J
authors.initials: J
authors.lastname: Koike
authors.forename: K
authors.initials: K
authors.lastname: Ujiie
authors.forename: K
authors.initials: K
authors.lastname: Tomita
authors.forename: T
authors.initials: T
authors.lastname: Shiigai
mesh_terms: D002244:Carbon / Q000627:therapeutic use*; D003401:Creatine / Q000097:blood; D003404:Creatinine / Q000652:urine; D018753:Diet, Protein-Restricted; D018450:Disease Progression; D006801:Humans; D007676:Kidney Failure, Chronic / Q000178:diet therapy / Q000188:drug therapy*; D007677:Kidney Function Tests; D008863:Microspheres; D010087:Oxides / Q000627:therapeutic use*; D011446:Prospective Studies; D014118:Toxins, Biological / Q000652:urine
chemical_list: D010087:Oxides; D014118:Toxins, Biological; D002244:Carbon; C040896:AST 120; D003404:Creatinine; D003401:Creatine