Abstract
Protein (albumin)-bound indoxyl sulfate is markedly increased in the serum of hemodialysis patients. Since protein-bound indoxyl sulfate cannot be removed efficiently by hemodialysis, we studied the effect of oral sorbent AST-120 on the serum concentration of indoxyl sulfate in hemodialysis patients.
The hemodialysis patients administered oral sorbent AST-120 showed a marked decrease in the prehemodialysis serum concentration of indoxyl sulfate as compared with control hemodialysis patients. The serum concentration of creatinine and urea nitrogen, however, did not decrease after the oral administration of AST-120. Administration of AST-120 to hemodialysis patients with pruritus caused an improvement in itching.
AST-120 was effective in decreasing the serum concentration of albumin-bound indoxyl sulfate in hemodialysis patients. This was due to the inhibition of indoxyl sulfate synthesis in the liver as a result of the adsorption of indole, a precursor of indoxyl sulfate, in the intestine.
