AST-120 Treatment in Pre-Dialysis Period Affects the Prognosis in Patients on Hemodialysis

Ueda, Haruhiko; Shibahara, Nobuhisa; Takagi, Shizuko; Inoue, Toru; Katsuoka, Yoji

doi:10.1080/08860220802356531

Cited by 78 publications

(63 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Administration of the oral adsorbent AST-120 before initiating dialysis has been shown to not only improve the survival rate in patients on HD 144,145 but also, delay the onset of HD in patients with CKD. 146 AST-120 is also associated with a reduction in carotid intima media thickness and arterial stiffness in patients with CKD and without diabetes.…”

Section: Inhibition Of Gastrointestinal Absorptionmentioning

confidence: 99%

Uremic Toxicity of Advanced Glycation End Products in CKD

Stinghen

Massy

Vlassara

et al. 2016

Journal of the American Society of Nephrology

195

175

View full text Add to dashboard Cite

Advanced glycation end products (AGEs), a heterogeneous group of compounds formed by nonenzymatic glycation reactions between reducing sugars and amino acids, lipids, or DNA, are formed not only in the presence of hyperglycemia, but also in diseases associated with high levels of oxidative stress, such as CKD. In chronic renal failure, higher circulating AGE levels result from increased formation and decreased renal clearance. Interactions between AGEs and their receptors, including advanced glycation end product-specific receptor (RAGE), trigger various intracellular events, such as oxidative stress and inflammation, leading to cardiovascular complications. Although patients with CKD have a higher burden of cardiovascular disease, the relationship between AGEs and cardiovascular disease in patients with CKD is not fully characterized. In this paper, we review the various deleterious effects of AGEs in CKD that lead to cardiovascular complications and the role of these AGEs in diabetic nephropathy. We also discuss potential pharmacologic approaches to circumvent these deleterious effects by reducing exogenous and endogenous sources of AGEs, increasing the breakdown of existing AGEs, or inhibiting AGE-induced inflammation. Finally, we speculate on preventive and therapeutic strategies that focus on the AGE-RAGE axis to prevent vascular complications in patients with CKD.

show abstract

Section: Inhibition Of Gastrointestinal Absorptionmentioning

confidence: 99%

Uremic Toxicity of Advanced Glycation End Products in CKD

Stinghen

Massy

Vlassara

et al. 2016

Journal of the American Society of Nephrology

195

175

View full text Add to dashboard Cite

show abstract

“…Nakabayashi et al used supplemental symbiotics (probiotic combined with prebiotic) for two weeks and observed significant reductions in p-cresyl sulfate levels and the normalization of bowel habits in hemodialysis patients [88]. Furthermore, AST-120, an oral adsorbent capable of binding solutes and preventing their intestinal absorption represents a type of therapy able to reduce the levels of indoxyl sulfate [89]. In addition, a recent study demonstrated that supplementation with AST 120 appears to improve intestinal barrier, inflammation and oxidative stress of CKD [90].…”

mentioning

confidence: 99%

Role of Altered Intestinal Microbiota in Systemic Inflammation and Cardiovascular Disease in Chronic Kidney Disease

et al. 2014

View full text Add to dashboard Cite

The normal intestinal microbiota plays a major role in the maintenance of health and disease prevention. In fact, the alteration of the intestinal microbiota has been shown to contribute to the pathogenesis of several pathological conditions, including obesity and insulin resistance, among others. Recent studies have revealed profound alterations of the gut microbial flora in patients and animals with chronic kidney disease (CKD). Alterations in the composition of the microbiome in CKD may contribute to the systemic inflammation and accumulation of gut-derived uremic toxins, which play a central role in the pathogenesis of accelerated cardiovascular disease and numerous other CKD-associated complications. This review is intended to provide a concise description of the potential role of the CKD-associated changes in the gut microbiome and its potential role the pathogenesis of inflammation and uremic toxicity. In addition, the potential efficacy of pre- and pro-biotics in the restoration of the microbiome is briefly described.

show abstract

“…116,136,[150][151][152][153] In CKD patients, AST-120 has been shown to improve estimated creatinine clearance, 154 to delay the progression to ESRD, 155 and to improve survival. 156 Two large-scale trials are currently ongoing testing the role of AST-120 in CKD populations. 157,158 Cardiorenal-protective effects of AST-120 recently have been demonstrated in a small, uncontrolled trial of chronic HF patients with moderate CKD.…”

Section: Heartmentioning

confidence: 99%

Cardiorenal Syndrome

Lekawanvijit

Kompa

Wang

et al. 2012

Circulation Research

151

View full text Add to dashboard Cite

Cardiorenal syndrome is a condition in which a complex interrelationship between cardiac dysfunction and renal dysfunction exists. Despite advances in treatment of both cardiovascular and kidney disease, cardiorenal syndrome remains a major global health problem. Characteristic of the pathophysiology of cardiorenal syndrome is bidirectional cross-talk; mediators/substances activated by the disease state of 1 organ can play a role in worsening dysfunction of the other by exerting their biologically harmful effects, leading to the progression of the syndrome. Accumulation of uremic toxins is a hallmark of renal excretory dysfunction. Removal of some toxins by conventional dialysis is particularly problematic because of their high protein binding. In this review, we demonstrate that protein-bound uremic toxins may play an important role in progression of cardiovascular disease in the setting of chronic kidney disease. The highly protein-bound uremic toxin indoxyl sulfate has emerged as a potent toxin adversely affecting both the kidney and heart. Direct cardiac effects of this toxin have been recently demonstrated both in vitro and in vivo. Specifically, potent fibrogenic and prohypertrophic effects, as well as oxidative stress-inducing effects, appear to play a central role in both renal and cardiac pathology. Many of these adverse effects can be suppressed by use of a gut adsorbent, AST-120. Potential mechanisms underlying indoxyl sulfate−induced cardiorenal fibrosis are discussed. Future research and clinical implications conclude this review.

show abstract

AST-120 Treatment in Pre-Dialysis Period Affects the Prognosis in Patients on Hemodialysis

Cited by 78 publications

References 25 publications

Uremic Toxicity of Advanced Glycation End Products in CKD

Uremic Toxicity of Advanced Glycation End Products in CKD

Role of Altered Intestinal Microbiota in Systemic Inflammation and Cardiovascular Disease in Chronic Kidney Disease

Cardiorenal Syndrome

Contact Info

Product

Resources

About