Clinical analysis of renoprotective responding patients administrated with oral adsorbent in chronic renal failure secondary to chronic glomerulonephritis.
An oral adsorbent (AST-120) that removes uremic toxin has attenuated the progression of renal dysfunction. Although there were decreased serum creatinine (Scr) levels observed during administration, it is expected that the action of an oral adsorbent is different according to the patient. In the present study, the difference in the background was clarified.


METHODS
A total of 842 patients whose Scr had increased from 3.8 to 4.8 mg/dL during the prior 5.2 months were investigated. Antihypertensive medications and dietary protein intake were unmodified during 6 months administration. The patients were divided into three efficacy groups based on the changes in Scr level: those who had a decrease in Scr were grouped as Group A (N = 290), while those with a < 1.5-fold increase were defined as Group B (N = 428) and those with a > or = 1.5-fold increase were defined as Group C (N = 124).


RESULTS
Before administration, these three groups were indistinguishable by the Scr level. No Group A patient went onto dialysis, whereas 12% and 40% of Group B and C patients, respectively, required dialysis. In Group A, the slopes of 1/Scr over time, serum urea nitrogen, uric acid, phosphate, total protein, and diastolic blood pressure were all improved. Group B improved moderately and Group C showed less improvement.


CONCLUSIONS
In this study, a fairly large number of patients (29% of the population) were believed to be the first case to report the reversibility of severe chronic renal failure. Except in patients with hypoproteinemia, hypercholesterolemia, anemia or hypertension, AST-120 either attenuates or arrests the progression in patients with severe chronic glomerulonephritis.
Sanaka
Tsutomu
T
Department of Nephrology and Blood Purification, Daini Hospital Medical Center, Tokyo Women's Medical Univesity, Tokyo, Japan. akakc@dnh.twmu.ac.jp
Akizawa
Tadao
T
Koide
Keizo
K
Koshikawa
Shozo
S
D000284:Administration, Oral; D000327:Adsorption; D000328:Adult; D000704:Analysis of Variance; D002244:Carbon / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D018450:Disease Progression; D005260:Female; D005921:Glomerulonephritis / Q000150:complications*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010087:Oxides / Q000627:therapeutic use*; D016896:Treatment Outcome; D014511:Uremia / Q000378:metabolism / Q000503:physiopathology
D010087:Oxides; D002244:Carbon; C040896:AST 120