[Effect of oral adsorbent AST-120 under standard treatment of care in patients with chronic renal failure].
BACKGROUND
Oral adsorbent AST-120 reduces uremic toxins, such as indoxyl sulfate, and retards the progression of chronic kidney disease (CKD). The present study was conducted to elucidate the association between the progression of CKD and the combined effect of AST-120 and standard care based on diet therapy and medications such as ACE inhibitor and ARB.


METHODS
Retrospective analysis was performed using forty-four CKD patients (chronic glomerular nephritis 16, diabetic nephropathy 9, nephrosclerosis 13, and others 6) who were treated by AST-120 during the period from October, 2001 through December, 2004 and followed up for more than 6 months. The selection criteria were an estimated creatinine clearance (eCCr) of 30 mL/min or under at the initiation of treatment and a negative change in eCCr over time (DeltaeCCr (mL/min/year)) before AST-120 treatment. The eCCr was calculated using the Cockcroft-Gault equation and the DeltaeCCr was evaluated as a marker for the progression of chronic renal failure.


RESULTS
Overall DeltaeCCr before and after AST-120 treatment significantly improved from -7.28 +/- 6.33 to -4.29 +/- 5.09 (paired Wilcoxon test, p < 0.05). AST-120 led to greater improvement of DeltaeCCr in patients with an DeltaeCCr of less than -10 mL/min/year before AST-120 treatment and who had higher blood uric acid, urinary protein, and urinary specific gravity valves.


CONCLUSIONS
This finding suggests that AST-120 treatment is effective in slowing the progression of chronic kidney disease, especially, in patients who exhibit a poor response to standard care.
Yoshida
Izumi
I
Division of Nephrology, First Department of Integrated Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan.
Komada
Takanori
T
Sakuma
Yuki
Y
Mori
Honami
H
Funayama
Izumi
I
Tabei
Kaoru
K
D000327:Adsorption; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002244:Carbon / Q000008:administration & dosage*; D003131:Combined Modality Therapy; D018753:Diet, Protein-Restricted; D004039:Diet, Sodium-Restricted; D018450:Disease Progression; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008019:Life Style; D010087:Oxides / Q000008:administration & dosage*; D012189:Retrospective Studies; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D010087:Oxides; D002244:Carbon; C040896:AST 120