Efficacy of adsorbent in delaying dialysis initiation among chronic kidney disease patients

OBJECTIVE

By adsorbing uremic toxins, the oral adsorbent AST-120 is anticipated to suppress progression of chronic kidney disease (CKD) and hence delay initiation of dialysis. We conducted a retrospective study to clarify the efficacy of AST-120 in combination with the current basic treatments in CKD patients.

METHODS

Among 130 patients who initiated dialysis, 56 patients who had taken AST-120 and 56 pair-matched patients who had not taken AST-120 were analyzed. Matching was conducted using propensity scores. Cumulative dialysis initiation rate and change in estimated glomerular filtration rate (_eGFR) were compared between the two groups.

RESULTS

At baseline, 42.9% of patients in the AST-120 group and 35.7% in the control group had diabetic nephropathy (DN) as the primary renal disease, and the mean eGFR rates were 11.7 ± 7.9 and 11.0 ± 9.3 mL/min, respectively. The 24-month cumulative dialysis initiation rates were 64.3% in the AST-120 group and 94.5% in the control group (p _ 0.001). When _eGFR before and after baseline were compared, the speed of eGFR reduction was significantly retarded in the AST-120 group (p _ 0.001), while no difference was observed in the control group.

CONCLUSIONS

AST-120 may further improve the effectiveness of the current basic treatment in delaying CKD progression.