Predictive factors for efficacy of AST-120 treatment in diabetic nephropathy: A prospective single-arm, open-label, multi-center study

You Cheol Hwang, Se Won Kim, Kyu Yeon Hur, Bong Soo Cha, In Joo Kim, Tae Sun Park, Sei Hyun Baik, Kun Ho Yoon, Kwan Woo Lee, In Kyu Lee, Moon Kyu Lee

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2 Citations (Scopus)

Abstract

Background: Removal of uremic toxins such as indoxyl sulfate by AST-120 is known to improve renal function and delay the initiation of dialysis in patients with advanced chronic kidney disease. However, it is unclear whether the addition of AST-120 to conventional treatments is effective in delaying the progression of renal dysfunction in patients with diabetic nephropathy. Methods: A total of 100 patients with type 2 diabetes and renal dysfunction (serum creatinine levels ranging from 1.5 to 3.0 mg/dL) were recruited from eight centers in Korea and treated with AST-120 (6 g/day) for 24 weeks. The primary endpoint was improvement in renal function measured as the gradient of the reciprocal serum creatinine level (1/sCr) over time (i.e., the ratio of 1/sCr time slope for post- to pre-AST-120 therapy). A response was defined as a ratio change of the regression coefficient of 1/sCr ≤ 0.90. Results: Renal function improved in 80.3% of patients (61/76) after 24 weeks of AST-120 treatment. There were no differences between responder and non-responder groups in baseline characteristics except for diastolic blood pressure (73.5 ± 9.5 mmHg in the responder group vs. 79.3 ± 11.1 mmHg in the non-responder group; P = 0.046). Serum lipid peroxidation level decreased significantly in the responder group (from 2.25 ± 0.56 μmol/L to 1.91 ± 0.72 μmol/L; P = 0.002) but not in the non-responder group. Conclusion: The addition of AST-120 to conventional treatments may delay the progression of renal dysfunction in diabetic nephropathy. The antioxidant effect of AST-120 might contribute to improvement in renal function.

Original languageEnglish
Article numbere117
JournalJournal of Korean medical science
Volume34
Issue number15
DOIs
Publication statusPublished - 2019 Apr 22

Keywords

  • Antioxidants
  • Creatinine
  • Diabetic Nephropathy
  • Indoxyl Sulfate
  • Oxidative Stress

ASJC Scopus subject areas

  • Medicine(all)

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    Hwang, Y. C., Kim, S. W., Hur, K. Y., Cha, B. S., Kim, I. J., Park, T. S., Baik, S. H., Yoon, K. H., Lee, K. W., Lee, I. K., & Lee, M. K. (2019). Predictive factors for efficacy of AST-120 treatment in diabetic nephropathy: A prospective single-arm, open-label, multi-center study. Journal of Korean medical science, 34(15), [e117]. https://doi.org/10.3346/jkms.2019.34.e117