Therapeutic effects of oral sorbent in undialyzed uremia

The present study was carried out to clarify whether an oral sorbent, AST-120 (Kureha Chemical Ind Co, Tokyo), may postpone the initiation of dialysis therapy. The subjects were randomly divided into two groups, control and AST. The AST group consisted of 27 undialyzed uremic patients. Serum creatine concentrations (SCr) were 4.3 to 8.1 mg/dL (5.8 +/- 1.1 mg/dL, mean +/- SD). The control group consisted of 24 uremic patients who were not given AST-120 during the conservative therapy period before the initiation of hemodialysis. AST-120 (3.2 to 7.2 g/d) was administered to the patients in the AST group for 2.4 to 30.1 months (13.2 +/- 7.4) before the initiation of hemodialysis. The slopes of reciprocal creatinine v time in the control group were -1,251 +/- 856 x 10(-5) dL/mg/month during the 6 to 12 months before the initiation of dialysis therapy, and in the AST group, they were -1,004 +/- 1,012 x 10(-5) dL/mg/month before administration, and -347 +/- 509 x 10(-5) dL/mg/month after administration of AST-120 (P less than 0.01). All 24 patients in the control group and 21 of 27 in the AST group were introduced to hemodialysis. SCr and serum urea nitrogen (SUN) at the initiation of hemodialysis did not differ between the control and AST group: 10.8 +/- 2.6 and 11.0 +/- 2.2 mg/dL and 92.7 +/- 22.2 and 94.1 +/- 21.6 mg/dL, respectively. The times to the 50% undialyzed level were 5.0 months in the control group, and 14.3 months in the AST group.(ABSTRACT TRUNCATED AT 250 WORDS)