Effects of Oral Adsorbent AST-120 (Kremezin®) on the Progression of Chronic Kidney Disease

Abstract

Purpose: AST-120 is known to delay progression of chronic kidney disease (CKD) when combined with other proven therapy. AST-120 is an oral adsorbent for uremic toxin, such as indoxyl sulfate from the gastrointestinal tract. There have been a lot of studies to show its effect in other countries, but there are few studies done in Korea yet. Methods: 195 patients were included in the study (mean age, 64±14 years; diabetes mellitus (DM), 104 patients; male, 130 patients). The patients with CKD who started AST-120 and maintained the medication for at least 6 months were enrolled. The patients’ laboratory results for 6 months before and after administrating AST-120 was surveyed. Then the rate of patients’ renal functional deterioration was compared before and after AST-120. In addition, adverse effects during the medication were surveyed. Results: There were no statistically significant differences in laboratory data between before and after AST-120 administration. But, after administrating AST-120, the renal deterioration slope has blunted significantly from -0.0123±0.0318 to -0.0013±0.0184 dL/mg/month (p<0.01) in 1/sCr and from -1.1423± 2.3906 to 0.0639±1.3825 ml/min/1.73m2/month (p<0.01) in estimated glomerular filtration rate (eGFR). There were no differences between DM and non-DM patients in the effect of AST-120, as well as ages over 70 and below 70. There were no serious adverse effects during medication. Conclusion: This study showed that AST-120 had additive effect on retarding the CKD progression when combined with established therapy regardless of DM and ages without serious adverse effects.