Prediction of Patients Who Can Benefit from Oral Intestinal Sorbent AST-120

Indoxyl sulfate (IS) increases the expression of fibrogenic genes while it impairs anti- oxidative systems and down-regulates Klotho expression in the kidney. AST-120, which adsorbs uremic toxins and precursors including indole, can decrease serum and urinary levels of IS, the levels of advanced glycation end products (AGEs), and 8-hydroxydeoxyguanosine while it increases the renal expression of Klotho. In addition to the improvement of glomerular sclerosis, serum creatinine levels, and the survival in chronic kidney disease (CKD) animal models, AST-120 alleviated uremic symptoms and slowed the progression of renal dysfunction through small clinical investigations. There have been large clinical studies using AST-120.1-3 But they only recruited patients with advanced renal dysfunction and failed to prove the effectiveness of AST-120 except that Carbonaceous oral Adsorbent's effectiveness on Progression of CKD study showed less decrease of the estimated glomerular filtration rate (eGFR) in the AST-120 group.1 KCI Citation Count: 0