AST-120 Treatment in Pre-Dialysis Period Affects the Prognosis in Patients on Hemodialysis
- 1 January 2008
- journal article
- Published by Informa UK Limited in Renal Failure
- Vol. 30 (9), 856-860
- https://doi.org/10.1080/08860220802356531
Abstract
An oral adsorbent, AST-120, has been shown to retard the deterioration of renal function in patients with chronic kidney disease (CKD) by decreasing serum nephrotoxic substances such as indoxyl sulfate. Recent studies have suggested that a high level of serum indoxyl sulfate may be one of the mechanisms underlying the progression of atherosclerotic lesion, which is the leading cause of cardiovascular event or death in dialysis patients. In this study, we examined retrospectively whether AST-120 given to patients in the pre-dialysis period influences the prognosis after the initiation of dialysis. One hundred and ninety-two CKD patients on dialysis were studied. The survival and causes of death after the initiation of dialysis were compared between patients who were administrated AST-120 (AST-120 group, n = 101) and those not administrated AST-120 (non-AST-120 group, n = 91) prior to the initiation of dialysis. The five-year survival rate was 72.6% in the AST-120 group and 52.6% in the non-AST-120 group, and was significantly higher in the AST-120 group (p = 0.018). The risk of death was increased 1.91-fold in the non-AST-120 group. However, no difference in the causes of death was observed between two groups. This study suggests that AST-120 given prior to the initiation of dialysis improves the prognosis of CKD patients under dialysis, although there is no association between AST-120 treatment and death caused by cardiovascular diseases such as heart failure, myocardial infarction, and cerebral hemorrhage. Further studies are needed to elucidate the effect of AST-120 on cardiovascular events and the prognosis in dialysis patients.Keywords
This publication has 24 references indexed in Scilit:
- Indoxyl sulfate stimulates proliferation of rat vascular smooth muscle cellsKidney International, 2006
- Free serum concentrations of the protein-bound retention solute p-cresol predict mortality in hemodialysis patientsKidney International, 2006
- The uremic solutes p-cresol and indoxyl sulfate inhibit endothelial proliferation and wound repairKidney International, 2004
- Postischemic vasodilation, endothelial activation, and cardiovascular remodeling in end-stage renal diseaseKidney International, 2000
- Atherosclerosis — An Inflammatory DiseaseNew England Journal of Medicine, 1999
- Cardiovascular disease in patients with chronic renal failureThe Lancet, 1996
- Increased cardiovascular risk factors and features of endothelial activation and dysfunction in dialyzed uremic patientsKidney International, 1994
- Progression of Glomerular Sclerosis in Experimental Uremic Rats by Administration of Indole, a Precursor of Indoxyl SulfateAmerican Journal of Nephrology, 1994
- Endothelin in Renal FailureNephrology Dialysis Transplantation, 1990
- Therapeutic Effects of Oral Sorbent in Undialyzed UremiaAmerican Journal of Kidney Diseases, 1988