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AST-120 improves microvascular endothelial dysfunction in end-stage renal disease patients receiving hemodialysis

Title
AST-120 improves microvascular endothelial dysfunction in end-stage renal disease patients receiving hemodialysis
Authors
Ryu J.-H.Yu M.Lee S.Ryu D.-R.Kim S.-J.Kang D.-H.Choi K.B.
Ewha Authors
강덕희최규복김승정류동열유민아
SCOPUS Author ID
강덕희scopus; 최규복scopus; 김승정scopus; 류동열scopus; 유민아scopus
Issue Date
2016
Journal Title
Yonsei Medical Journal
ISSN
0513-5796JCR Link
Citation
vol. 57, no. 4, pp. 942 - 949
Keywords
AST-120Endothelial dysfunctionHemodialysisIndoxyl sulfateLaser-Doppler flowmetryMicrovascular circulation
Publisher
Yonsei University College of Medicine
Indexed
SCI; SCIE; SCOPUS; KCI WOS scopus
Abstract
Purpose: Endothelial dysfunction (ED) is a pivotal phenomenon in the development of cardiovascular disease (CVD) in patients receiving hemodialysis (HD). Indoxyl sulfate (IS) is a known uremic toxin that induces ED in patients with chronic kidney disease. The aim of this study was to investigate whether AST-120, an absorbent of IS, improves microvascular or macrovascular ED in HD patients. Materials and Methods: We conducted a prospective, case-controlled trial. Fourteen patients each were enrolled in respective AST-120 and control groups. The subjects in the AST-120 group were treated with AST-120 (6 g/day) for 6 months. Microvascular function was assessed by laser Doppler flowmetry using iontophoresis of acetylcholine (Ach) and sodium nitroprusside (SNP) at baseline and again at 3 and 6 months. Carotid arterial intima-media thickness (cIMT) and flow-mediated vasodilation were measured at baseline and 6 months. The Wilcoxon rank test was used to compare values before and after AST-120 treatment. Results: Ach-induced iontophoresis (endothelium-dependent response) was dramatically ameliorated at 3 months and 6 months in the AST-120 group. SNP-induced response showed delayed improvement only at 6 months in the AST-120 group. The IS level was decreased at 3 months in the AST-120 group, but remained stable thereafter. cIMT was significantly reduced after AST-120 treatment. No significant complications in patients taking AST-120 were reported. Conclusion: AST-120 ameliorated microvascular ED and cIMT in HD patients. A randomized study including a larger population will be required to establish a definitive role of AST-120 as a preventive medication for CVD in HD patients. © Yonsei University College of Medicine 2016.
DOI
10.3349/ymj.2016.57.4.942
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의학전문대학원 > 의학과 > Journal papers
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