Effects of AST-120 on blood concentrations of protein-bound uremic toxins and biomarkers of cardiovascular risk in chronic dialysis patients

Blood Purif. 2014;37(1):76-83. doi: 10.1159/000357641. Epub 2014 Feb 22.

Abstract

Background: Removal of protein-bound uremic toxins by dialysis therapy is limited. The effect of oral adsorbent AST-120 in chronic dialysis patients has rarely been investigated.

Methods: AST-120 was administered 6.0 g/day for 3 months in 69 chronic dialysis patients. The blood concentrations of indoxyl sulfate, p-cresol sulfate and biomarkers of cardiovascular risk were determined before and after AST-120 treatment.

Results: AST-120 significantly decreased both the total and free forms of indoxyl sulfate and p-cresol sulfate ranging from 21.9 to 58.3%. There were significant simultaneous changes of the soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK, 24% increase), malondialdehyde (14% decrease) and interleukin-6 (19% decrease). A significant association between the decrease of indoxyl sulfate and changes of sTWEAK and interleukin-6 was noted.

Conclusions: AST-120 effectively decreased indoxyl sulfate and p-cresol sulfate levels in both total and free forms. AST-120 also improved the profile of cardiovascular biomarkers.

MeSH terms

  • Adsorption
  • Adult
  • Biomarkers / blood
  • Carbon / administration & dosage
  • Carbon / therapeutic use*
  • Cardiovascular Diseases / blood*
  • Cardiovascular Diseases / etiology
  • Cresols / blood*
  • Cresols / isolation & purification
  • Cytokine TWEAK
  • Female
  • Humans
  • Indican / blood*
  • Indican / isolation & purification
  • Interleukin-6 / blood
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Male
  • Malondialdehyde / blood
  • Middle Aged
  • Oxides / administration & dosage
  • Oxides / therapeutic use*
  • Protein Binding
  • Renal Dialysis*
  • Risk Factors
  • Sulfuric Acid Esters / blood*
  • Sulfuric Acid Esters / isolation & purification
  • Tumor Necrosis Factors / blood
  • Uremia / blood
  • Uremia / complications
  • Uremia / therapy*

Substances

  • Biomarkers
  • Cresols
  • Cytokine TWEAK
  • Interleukin-6
  • Oxides
  • Sulfuric Acid Esters
  • TNFSF12 protein, human
  • Tumor Necrosis Factors
  • Malondialdehyde
  • 4-cresol sulfate
  • Carbon
  • AST 120
  • Indican