title: Long-term effects of AST-120 on the progression and prognosis of pre-dialysis chronic kidney disease: a 5-year retrospective study.
abstract: AST-120 has been used widely in Japan to slow the deterioration of renal function in patients with chronic kidney disease (CKD) by decreasing uremic toxins. The heart and the kidney are closely related, with cardiorenal interaction being very important. This retrospective study examined whether AST-120 influences the prevalence of dialysis induction, mortality, and cardiac and stroke events in CKD patients. The study included 278 patients diagnosed with chronic renal failure (CKD stage: III-V) in 2006. Of these patients, 128 received AST-120 (6 g/day), while the remaining 150 patients did not. A log-rank test was performed to compare dialysis induction, mortality, and cardiac and stroke events in the two groups. Univariate and multivariate Cox proportional hazard regression analyses were used to identify the potential factors that contributed to dialysis induction, mortality, and cardiac and stroke events over the next 5 years. Patient profiles before the study were almost the same other than age, primary disease (DM or non-DM) and urine volume. The prevalence of dialysis induction, mortality, and cardiac and stroke events in patients treated with AST-120 was significantly lower after 3 and 5 years (p < 0.0001) compared with the prevalence observed in the untreated patients. The absence of AST-120 treatment was associated independently with a high risk of dialysis induction (hazard ratio 4.979, 95 % CI 3.502-7.079, p < 0.0001), mortality (4.536, 2.666-7.720, p < 0.0001), cardiac event (3.590, 2.572-5.011, p < 0.001) and stroke (1.949, 1.342-2.829, p = 0.0005). The results of this retrospective analysis suggest that long-term treatment with AST-120 may improve the prognosis of CKD patients in the pre-dialysis stage. Long-term (i.e., >5 years) prospective randomized studies are needed to confirm the findings of the current study.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Matsudo, Japan.
authors.forename: Eiichi
authors.initials: E
authors.lastname: Sato
authors.affiliation: Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tanaka
authors.affiliation: Department of Advanced Cardiology, Saga University, Saga, Japan.
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Oyama
authors.affiliation: Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
authors.forename: Ayumu
authors.initials: A
authors.lastname: Yamasaki
authors.affiliation: Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Shimomura
authors.affiliation: Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Hiwatashi
authors.affiliation: Department of Pathology, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ueda
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Matsudo, Japan.
authors.forename: Mayuko
authors.initials: M
authors.lastname: Amaha
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Matsudo, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Nomura
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Matsudo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Matsumura
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Shinmatsudo Central General Hospital, Matsudo, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Cardiovascular Medicine, Saga University, 5-1-1 Nabeshima, Saga, 849-8501, Japan. node@cc.saga-u.ac.jp.
authors.forename: Koichi
authors.initials: K
authors.lastname: Node
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002244:Carbon / Q000008:administration & dosage* / Q000009:adverse effects; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010087:Oxides / Q000008:administration & dosage* / Q000009:adverse effects; D011379:Prognosis; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult
chemical_list: D010087:Oxides; D002244:Carbon; C040896:AST 120
keywords: AST-120; Chronic kidney disease; Clinical outcome; Pre-dialysis chronic renal failure