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Kidney Week

Abstract: SA-PO901

Amelioration of Uremic Toxin Indoxyl Sulfate by Oral Chito-Oligosaccharide in Predialysis Patients: A Randomized Controlled Trial

Session Information

Category: CKD (Non-Dialysis)

  • 2202 CKD (Non-Dialysis): Clinical‚ Outcomes‚ and Trials

Authors

  • Sirisuksakun, Chumphon, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Thimachai, Paramat, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Tasanavipas, Pamila, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Siriwattanasit, Narongrit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Inkong, Pitchamon, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Varothai, Narittaya, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Chaiprasert, Amnart, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Nata, Naowanit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Tangwonglert, Theerasak, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Kaewput, Wisit, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Satirapoj, Bancha, Phramongkutklao College of Medicine, Bangkok, Thailand
  • Supasyndh, Ouppatham, Phramongkutklao College of Medicine, Bangkok, Thailand
Background

Chito-oligosaccharide (COS) can bind indoxyl sulfate (IS) from protein-based foods. However, sparse data of COS on serum IS was studied. The study aimed to determine the efficacy of COS on serum IS reduction and delay of chronic kidney disease (CKD) progression.

Methods

A randomized, double-blind, placebo-controlled trial was conducted in CKD patients with eGFR < 20 ml/min/1.73 m2 during September 2021 to February 2022. Treatment group received oral COS 500 mg once daily for 12-week. The other group received a placebo, which was identical to COS capsule. Patient’s baseline characteristics and serum IS were collected at baseline, week-4 and week-12.

Results

Forty-seven out of fifty participants were enrolled and completed the study. The mean (SD) of IS level at baseline in the treatment (N=26) and placebo (N=21) group were 585.1 (402.2) and 466.8 (421.5) ng/ml (p=0.4). There was significant decrease in IS level at week-4 and week-12 in the treatment group (p=0.006 and p=0.007) but not in the placebo group, in which the IS level was increased significantly at week-12 (p=0.002). The mean of IS level at the end of the trial was significantly lower in the treatment group with the mean difference (95% CI) -960.1 (-1384.6 to -535.5) ng/ml (p<0.001). The eGFR declined significantly in the placebo at week-4 and week-12 (p =0.022 and p=0.004) but not in the treatment group (p=0.497 and p=0.113). No serious adverse event was found.

Conclusion

Oral 12-weeks of COS demonstrates the reduction of serum IS level and stabilizes eGFR without significant adverse event.