title: Effect of combined treatment of oral sorbent with protein-restricted diet on change of reciprocal creatinine slope in patients with CRF.
abstract: BACKGROUND
  Low-protein diet (LPD) is one therapy and AST-120, an oral carbon adsorbent, is the other therapy to reduce blood levels of indoxyl sulfate in patients with chronic renal failure (CRF). Based on the different mechanisms of reducing indoxyl sulfate levels, the addition of AST-120 to an LPD was investigated.
  
  
  METHODS
  Seven hundred twenty-two patients with chronic glomerulonephritis (CGN) and 162 patients with diabetic nephropathy (DN) were stratified by protein intake: less than 0.50 g/kg/d (0.50-g/kg/d group), 0.51 to 0.65 g/kg/d (0.65-g/kg/d group), and 0.66 to 0.80 g/kg/d (0.80-g/kg/d group). To analyze the effect of combined AST-120 therapy (6 g/d) in patients on LPD therapy, the slope of the reciprocal of serum creatinine (1/Cr slope), which represents progression of CRF, was applied.
  
  
  RESULTS
  (1) In patients with CGN, the addition of AST-120 with an LPD was as follows: the 1/Cr slope in the 0.50-g/kg/d (n = 152), 0.65-g/kg/d (n = 318), and 0.80-g/kg/d (n = 252) groups changed significantly from -430 x 10(-5) to -83 x 10(-5), -333 x 10(-5) to -102 x 10(-5), and -431 x 10(-5) to -116 x 10(-5) dL/mg/wk. (2) In patients with DN, the addition of AST-120 with an LPD was as follows: the 1/Cr slope in the 0.65-g/kg/d (n = 74) and 0.80-g/kg/d (n = 68) groups changed significantly from -602 x 10(-5) to -125 x 10(-5) and -646 x 10(-5) to -185 x 10(-5) dL/mg/wk.
  
  
  CONCLUSIONS
  It is suggested that the addition of AST-120 to a mild LPD provides the comparable effect with a strict LPD in the point of suppressing the progress of CRF.
authors.affiliation: Department of Nephrology and Blood Purification, Daini Hospital Medical Center, Tokyo Women's Medical University, Tokyo 116-8567, Japan. sanakakc@dnh.twmu.ac.jp
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Sanaka
authors.forename: Kumiko
authors.initials: K
authors.lastname: Fujimoto
authors.forename: Jun
authors.initials: J
authors.lastname: Niwayama
authors.forename: Hideki
authors.initials: H
authors.lastname: Nishimura
authors.forename: Takashi
authors.initials: T
authors.lastname: Naito
authors.forename: Chieko
authors.initials: C
authors.lastname: Higuchi
authors.forename: Tadao
authors.initials: T
authors.lastname: Akizawa
authors.forename: Keizo
authors.initials: K
authors.lastname: Koide
authors.forename: Shozo
authors.initials: S
authors.lastname: Koshikawa
mesh_terms: D000284:Administration, Oral; D000327:Adsorption; D002244:Carbon / Q000008:administration & dosage*; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003404:Creatinine / Q000097:blood*; D003928:Diabetic Nephropathies / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy; D018753:Diet, Protein-Restricted / Q000379:methods*; D005260:Female; D005921:Glomerulonephritis / Q000097:blood / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000178:diet therapy* / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D010087:Oxides / Q000008:administration & dosage*
chemical_list: D010087:Oxides; D002244:Carbon; C040896:AST 120; D003404:Creatinine