Continuous Reduction of Protein-Bound Uraemic Toxins with Improved Oxidative Stress by Using the Oral Charcoal Adsorbent AST-120 in Haemodialysis Patients

Sci Rep. 2015 Sep 23:5:14381. doi: 10.1038/srep14381.

Abstract

Accumulation of protein-bound uraemic toxins (PBUTs) is one of the reasons for the development of uraemia-related complications including cardiovascular disease; however, conventional haemodialysis is limited in its ability to remove PBUTs. We aimed to examine whether the oral charcoal adsorbent AST-120 has an additive effect on PBUT removal in haemodialysis patients. During the 4-week study, anuric patients undergoing haemodialysis received AST-120 (6 g/day) in the last 2 weeks (n = 10) or the first 2 weeks (n = 10). Serum levels of total and free PBUTs such as indoxyl sulfate, p-cresyl sulfate, and phenyl sulfate at the pre- and postdialysis sessions were measured before and after AST-120 use and after discontinuation. Levels of the oxidative stress markers oxidized albumin and 8-isoprostane were also measured. AST-120 use induced dramatic reduction of indoxyl sulfate (total, 45.7% [33.2-50.5%]; free, 70.4% [44.8-79.8%]), p-cresyl sulfate (total, 31.1% [25.0-48.0%]; free, 63.5% [49.3-70.9%]), and phenyl sulfate (free, 50.6% [32.3-71.2%]) levels; however, this effect disappeared after the discontinuation of AST-120. AST-120 use also induced substantial reduction of the oxidized albumin and 8-isoprostane levels. In conclusion, oral administration of AST-120 had additive effects on the continuous reduction of some PBUTs in anuric patients undergoing haemodialysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / blood
  • Carbon / therapeutic use*
  • Cresols / blood
  • Dinoprost / analogs & derivatives
  • Dinoprost / blood
  • Female
  • Humans
  • Indican / blood
  • Male
  • Middle Aged
  • Oxidative Stress / physiology*
  • Oxides / therapeutic use*
  • Renal Dialysis*
  • Renal Insufficiency, Chronic / therapy*
  • Serum Albumin / analysis
  • Sulfuric Acid Esters / blood
  • Toxins, Biological / blood*
  • Uremia / blood
  • Uremia / therapy*

Substances

  • Biomarkers
  • Cresols
  • Oxides
  • Serum Albumin
  • Sulfuric Acid Esters
  • Toxins, Biological
  • 8-epi-prostaglandin F2alpha
  • 4-cresol sulfate
  • Carbon
  • AST 120
  • phenylsulfate
  • Dinoprost
  • Indican