Continuous Reduction of Protein-Bound Uraemic Toxins with Improved Oxidative Stress by Using the Oral Charcoal Adsorbent AST-120 in Haemodialysis Patients.
Continuous Reduction of Protein-Bound Uraemic Toxins with Improved Oxidative Stress by Using the Oral Charcoal Adsorbent AST-120 in Haemodialysis Patients.
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DOI：
10.1038/srep14381
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发表时间：
2015-09-23
影响因子：
4.6
通讯作者：
Narita I
中科院分区：
文献类型：
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作者：
Yamamoto S;Kazama JJ;Omori K;Matsuo K;Takahashi Y;Kawamura K;Matsuto T;Watanabe H;Maruyama T;Narita I
蛋白结合尿毒症毒素(PBUT)的积聚是导致包括心血管疾病在内的尿毒症相关并发症的原因之一；然而，传统的血液透析对PBUT的清除能力有限。我们的目的是检查口服木炭吸附剂AST-120是否对血液透析患者的PBUT清除具有相加作用。在为期4周的研究中，接受血液透析的无尿患者在最后2周(n 10)或头2周(n = 10)接受AST120(6 = g/天)治疗。分别在使用AST-120前后和停用AST-120后测定透析前后血清总PBUT和游离PBUT水平，包括吲哚硫酸盐、对甲酚硫酸盐和苯硫酸酯。同时检测氧化应激标志物氧化白蛋白和8-异前列腺素水平。使用AST-120后，吲哚硫酸盐(总，45.7%[33.2-50.5%]；游离态，70.4%[44.8-79.8%])、对甲酚硫酸盐(总，31.1%[25.0-48.0%]；游离态，63.5%[49.3-70.9%])和苯基硫酸酯(游离态，50.6%[32.3-71.2%])水平显著降低；但停止使用AST-120后，这种影响消失。使用AST-120还可显著降低氧化白蛋白和8-异前列腺素水平。综上所述，口服AST-120对血液透析无尿患者部分PBUT的持续降低有相加作用。
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.