- 期刊
- OpenAccess
AST-120 (Kremezin) Ameliorates Monocyte Activation and Oxidative Stress in Hemodialysis Patients
並列摘要
BACKGROUND: Accumulating evidence suggested that oxidative stress and inflammation are important risk factors for cardiovascular events in hemodialysis patients. The effects of an oral spherical adsorptive carbon preparntion, AST-120, on markers of microinflammation and oxidative stress remain unclear. The aim of this study was to evaluate the depurative effect of AST-120 on sever a l protein-bound uremic toxins such as p-cresol sulfate and indoxyl sulfate in patients receiving post-dilution on-line hemodiafiltration (OLHDF). Moreover, the effects of AST-120 on both inflammatory and oxidative stress markers were also studied. METHODS: A total of 30 stable chronic kidney disease (CKD) patients receiving post-dilution OLHDF were enrolled and randomly assigned to either the control group or the experimental group. Patients in the experimental group received AST-120 at a daily do se of 6 g for 3 months. Serum levels of protein-bound toxins, oxidative stress and inflammatory biomarkers before and after AST-12 0 treatments were measured. Moreover, percentages of proinflammatory monocytes were al so assessed. RESULTS: Administration of AST-120 for 3 months reduced significantly the plasma level s of indoxyl sulfate (33.5±10.7 vs. 20.4 ± 10.4 mg/L, P＜0.05) and p-cresol sulfate (34.7±15.8 vs. 16.2±10.7 mg/L, P＜0.05). In the experimental group, serum levels of E-(carboxymethyl) lysine (CML) and marker of protein oxidation, advanced oxidation protein products (AOPP), showed significant reducti on at 3 months (CML, 7.11±3.56 ng/mL vs. 4.61±1.75 ng/mL; P＜0.05 and AOPP 109.5±37.1 mol/L vs. 83.6±21.7 moI/L; P＜0.05). At the end of the study, there were significant decreases in proinflammatory monocytes and cytokines. CONCLUSIONS: The results suggested that administration of AST-120 decreases significantly plasma levels of some protein-bound uremic toxin s in patients on post-dilution OLHDF. In addition , it also suppresses oxidative stress and reduces the number of proinflammatory mononuclear cells in these patients.