Research Paper Volume 16, Issue 5 pp 4236—4249
AST-120 improved uremic pruritus by lowering indoxyl sulfate and inflammatory cytokines in hemodialysis patients
- 1 Division of Nephrology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- 2 Department and Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei 11490, Taiwan
- 3 Kidney Research Center, Department of Nephrology, Chang Gung Memorial Hospital, Taoyuan City 33303, Taiwan
- 4 School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 24205, Taiwan
- 5 Division of Nephrology, Department of Medicine, Fu Jen Catholic University Hospital, New Taipei City 24352, Taiwan
- 6 Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan
- 7 Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- 8 Division of Nephrology, Department of Internal Medicine, Tungs’ Taichung Metroharbour Hospital, Taichung 43503, Taiwan
- 9 Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- 10 Faculty of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- 11 Division of Nephrology, Department of Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 23142, Taiwan
- 12 School of Medicine, Buddhist Tzu Chi University, Hualien 97004, Taiwan
- 13 School of Post-Baccalaureate Chinese Medicine, Buddhist Tzu Chi University, Hualien 97004, Taiwan
- 14 Department of Nephrology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taoyuan City 33303, Taiwan
- 15 School of Public Health, National Defense Medical Center, Taipei 11490, Taiwan
- 16 Department of Public Health, College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan
- 17 Big Data Research Center, College of Medicine, Fu-Jen Catholic University, New Taipei City 24205, Taiwan
- 18 Division of Nephrology, Department of Internal Medicine, Cardinal-Tien Hospital, New Taipei City 23155, Taiwan
- 19 Division of Nephrology, Department of Medicine, Fu-Jen Catholic University Hospital, School of Medicine, Fu-Jen Catholic University, New Taipei City 24352, Taiwan
Received: September 14, 2023 Accepted: January 17, 2024 Published: February 21, 2024
https://doi.org/10.18632/aging.205580How to Cite
Copyright: © 2024 Wu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background and hypothesis: Pruritus is a common and distressing symptom that affects patients with chronic kidney disease. The concentration of protein bounded uremic toxin was associated with the uremic pruritus. The aim is to assess the efficacy of AST-120 for uremic pruritus in hemodialysis patients.
Materials and Methods: The participants were enrolled and then divided into the AST-120 treatment group and control group with a ratio of 2:1. All participants underwent pre-observation screenings two weeks before the study with three visits. In the treatment phase (week 1 to week 4), the treatment group added 6g/day of AST-120 along with routine anti-pruritic treatment. Visual analog scale (VAS) and biochemical parameters were measured.
Results: The VAS score began to be lower in the AST-120 treatment group after the 5th visiting (p < 0.05). The reduction in indoxyl sulfate (IS) at 5th week along with TNF-alpha. The reduction ratio of indoxyl sulfate correlated with reduction of parathyroid hormone.
Conclusion: This study has demonstrated that the four-week treatment of AST-120 decreased the severity of uremic pruritus in patients with ESRD. The concentration of IS and TNF-alpha decreased in the AST-120 treatment group. The reduction of iPTH correlated with the reduction of IS in the AST-120 treatment.