Effect of AST-120 in Chronic Kidney Disease Treatment: Still a Controversy?

Yamaguchi, Junna; Tanaka, Tetsuhiro; Inagi, Reiko

doi:10.1159/000453673

Cited by 47 publications

(30 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many RCTs have experienced AST-120 to reduce the progression to ESRD and CV mortality in CKD patients; many of these found a favorable effect in delaying dialysis initiation, while in experimental animals a favorable effect was observed in reducing CV complications. However, there are no reports that unequivocally demonstrate the improvement of renal endpoints and/or CVD [45] . Another inert compound, used mainly to reduce intestinal phosphate absorption, sevelamer, a non-absorbable poly-allylamine polymer, is shown to reduce Creactive protein and endotoxemia generated by the translocation of membrane lipopolysaccharides fragments of Gram-negative bacteria from intestinal lumen to circulation.…”

Section: Possible Therapeutic Interventionsmentioning

confidence: 99%

The Cardiovascular Burden in End-Stage Renal Disease

Cozzolino

Galassi

Pivari

et al. 2017

Contributions to Nephrology

View full text Add to dashboard Cite

It is well documented that chronic kidney disease patients have an extremely high risk of developing cardiovascular (CV) disease (CVD) compared to the general population. Declining renal function itself represents a continuum of CV risk, and in those individuals who survive to reach end-stage renal disease, the risk of suffering a cardiac event is uncomfortably and unacceptably high. Several pathophysiological pathways have been suggested to account for this, including endothelial dysfunction, dyslipidemia, inflammation, left ventricular hypertrophy, troponins, phosphate, vitamin D, fibroblast growth factor-23, and NT-proBNP. All these conditions and biomarkers may have clear associations with current and subsequent CVD.

show abstract

Section: Possible Therapeutic Interventionsmentioning

confidence: 99%

The Cardiovascular Burden in End-Stage Renal Disease

Cozzolino

Galassi

Pivari

et al. 2017

Contributions to Nephrology

View full text Add to dashboard Cite

show abstract

“…AST-120 can bind many low-molecular-weight compounds (100–10,000 kDa), including indole, the precursor of indoxyl sulfate, in the intestines and prevent indoxyl sulfate production [81]. AST-120 can also bind AGEs such as carboxymethyllysine and decrease serum levels of AGEs in patients with CKD [82].…”

Section: Therapeutic Targets Associated With Nutrition For Preventmentioning

confidence: 99%

Dietary Metabolites and Chronic Kidney Disease

2017

Self Cite

View full text Add to dashboard Cite

Dietary contents and their metabolites are closely related to chronic kidney disease (CKD) progression. Advanced glycated end products (AGEs) are a type of uremic toxin produced by glycation. AGE accumulation is not only the result of elevated glucose levels or reduced renal clearance capacity, but it also promotes CKD progression. Indoxyl sulfate, another uremic toxin derived from amino acid metabolism, accumulates as CKD progresses and induces tubulointerstitial fibrosis and glomerular sclerosis. Specific types of amino acids (d-serine) or fatty acids (palmitate) are reported to be closely associated with CKD progression. Promising therapeutic targets associated with nutrition include uremic toxin absorbents and inhibitors of AGEs or the receptor for AGEs (RAGE). Probiotics and prebiotics maintain gut flora balance and also prevent CKD progression by enhancing gut barriers and reducing uremic toxin formation. Nrf2 signaling not only ameliorates oxidative stress but also reduces elevated AGE levels. Bardoxolone methyl, an Nrf2 activator and NF-κB suppressor, has been tested as a therapeutic agent, but the phase 3 clinical trial was terminated owing to the high rate of cardiovascular events. However, a phase 2 trial has been initiated in Japan, and the preliminary analysis reveals promising results without an increase in cardiovascular events.

show abstract

“…AST-120, an oral spherical carbonaceous adsorbent approved and used in chronic kidney disease to decrease uremia by decreasing intestinal indole absorption and consequently indoxyl sulfate production [23] has been extrapolated to HE with promising results, but still in initial phases and further studies are needed to better characterize its role in the treatment of HE.…”

Section: Treatments On the Horizonmentioning

confidence: 99%

Ammonia

Lee¹,

Huang²

2019

Liver Disease and Surgery [Working Title]

View full text Add to dashboard Cite

Ammonia is a compound that is thought to be central to the pathogenesis of hepatic encephalopathy. It is an important biomarker and may also serve as a prognostic indicator in acute liver disease where ammonia levels may be predictive of cerebral edema and herniation. In this chapter, we aim to review and discuss its role in hepatic encephalopathy to include: the cycle within the human body, appropriate measurement and collection, confounding factors and differential diagnosis, the correlation between levels and development of encephalopathy, the physiopathology and increased morbiditymortality with the incremental rise, clinical utility of sequential measurement, and lastly, an overview of novel treatments and the tight interconnections with ammonia.

show abstract

Effect of AST-120 in Chronic Kidney Disease Treatment: Still a Controversy?

Cited by 47 publications

References 18 publications

The Cardiovascular Burden in End-Stage Renal Disease

The Cardiovascular Burden in End-Stage Renal Disease

Dietary Metabolites and Chronic Kidney Disease

Ammonia

Contact Info

Product

Resources

About