Effects of oral adsorbent AST-120 (Kremezin®) on the progression of chronic kidney disease

Abstract

[한글]

[영문]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 still there are few studies done in Korea. Method: One hundred and ninety five patients were included in the study (mean age, 64 ± 14 years; diabetic (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’ clinical parameter 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: 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). But there were no statistically significant differences in clinical and biochemical characteristics between before and after AST-120 administration. 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: AST-120 had additive effect on retarding the CKD progression when combined with established therapy regardless of DM and ages without serious adverse effects.