Effects of oral adsorbent AST-120 on the progression of chronic renal failure: a randomized controlled study.
Effects of oral adsorbent AST-120 on the progression of chronic renal failure: a randomized controlled study.
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口服吸附剂 AST-120 对慢性肾衰竭进展的影响：一项随机对照研究。
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发表时间：
1997
期刊：
影响因子：
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通讯作者：
T. Shiigai
中科院分区：
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作者：
A. Owada;M. Nakao;J. Koike;K. Ujiie;K. Tomita;T. Shiigai
这项前瞻性随机对照研究旨在检查口服吸附剂AST-120对严格低蛋白饮食（LPD）患者慢性肾功能衰竭（CRF）进展的影响。26例接受LPD治疗的CRF患者（血清肌酐3.0 - 8.6 mg/dl）被随机分配至对照组（N = 13）或AST-120组（N = 13）。采用1/Cr斜率和肌酐清除率（CCr）斜率估计CRF的进展率;采用HPLC测量尿毒症毒素、血清和尿硫酸吲哚酚（IS）、峰2a和胍基底物（GS）。在两组中，对6 - 12个月的基线观察期和12 - 24个月的治疗期（对照组和AST-120组分别为0.6 g/kg/天LPD单独给药或与6 g/天AST-120同时给药）进行比较。仅AST-120组的1/Cr斜率和CCr斜率在治疗期间显著降低。仅AST-120组在治疗期间血清和尿IS，但峰2a和GS均未显著降低。我们的结论是，AST-120与LPD同时给药可能是上级的LPD单药通过抑制硫酸吲哚酚的积累延缓CRF的进展。
This prospective, randomized controlled study was designed to examine the effects of oral adsorbent AST-120 on the progression of chronic renal failure (CRF) in patients on a strict low protein diet (LPD). Twenty-six patients with CRF (serum creatinine 3.0 to 8.6 mg/dl) on a LPD were randomly assigned to a control group (N = 13) or an AST-120 group (N = 13). The 1/Cr slope and creatinine clearance (CCr) slope were used to estimate the progression rate of CRF; uremic toxins, serum and urinary indoxyl sulfate (IS), peak 2a and guanidino substrates (GS) measured by HPLC. Comparisons were made between the baseline observation period for 6 to 12 months and the treatment period (0.6 g/kg/day of LPD alone or concurrent with 6 g/day of AST-120, for the control and the AST-120 groups, respectively) for 12 to 24 months in both groups. Both the 1/Cr slope and CCr slope were significantly lessened in the treatment period only in the AST-120 group. Serum and urinary IS, but neither peak 2a nor GS were significantly decreased in the treatment period only in the AST-120 group. We conclude that AST-120 administration concurrent with LPD may be superior to LPD alone in retarding the progression of CRF by inhibiting accumulation of indoxyl sulfate.