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Kidney Week

Abstract: SA-PO1182

Long-Term Renoprotective Effects of AST-120 (Kremezin) in Patients with CKD

Session Information

Category: CKD (Non-Dialysis)

  • 2302 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

  • Lin, Chih-Ching, Taipei Veterans General Hospital, Taipei City, Taiwan
  • Tseng, Chin-Te, Taipei Veterans General Hospital, Taipei City, Taiwan
Background

AST-120 (Kremezin), an oral carbon adsorbent, binds uremic toxins, reducing their absorption and potentially delaying disease progression to end-stage renal disease (ESRD) and the need for dialysis in patients with chronic kidney disease (CKD). The study aims to evaluate the effects of AST-120 in CKD patients without prior history of renal replacement therapy in a 10-year period.

Methods

The study enrolled 344 CKD stage 3-5 patients. A propensity score weighted comparison was conducted on the 2 groups of patients (AST-120 group, n=173; non-AST-120 group, n=171). The primary outcome was the 10-year incidence of the composite outcome of ESRD or death. Survival analysis, using Kaplan-Meier curves and weighted univariate Cox proportional hazards models, was conducted to assess treatment effects with statistical significance set at p-value <0.05.

Results

The AST-120 group showed significantly better prognosis at 8 years (P=0.006, Figure 1; hazard ratio=0.56, P=0.02, Figure 2B). In the subgroup analysis at 10 years, AST-120 was associated with a significantly lower risk for the primary outcome in CKD stage 4 patients (hazard ratio=0.24, P=0.009; Figure 2D). However, for the 10-year prognosis in CKD stage 3-5 patients, AST-120 only demonstrated borderline significance (P=0.08).

Conclusion

AST-120 demonstrated significant long-term renoprotective effects at 8 years in CKD stage 3-5 patients and at 10 years in CKD stage 4 patients.

8-Year Survival Free from ESRD or Mortality

Risk of ESRD or Mortality at 8 and 10 Years

Digital Object Identifier (DOI)