Cardiorenal protective effect of the oral uremic toxin absorbent AST-120 in chronic heart disease patients with moderate CKD

J Nephrol. Sep-Oct 2010;23(5):535-40.


Background: The detailed mechanisms and treatment methods of chronic kidney disease (CKD) in patients with chronic heart failure (CHF) are not fully understood. We conducted a prospective study in CHF patients manifesting CKD to examine if AST-120 (Kremezin) improves cardiac and renal functions.

Methods: Twenty outpatients with CHF manifesting moderate CKD (serum creatinine 1.3-2.0 mg/dL) were studied. The patients had received AST-120 at a dosage of 6 g/day in combination with existing medications for 24 months. Some parameters of kidney and heart function were monitored. Also the cumulative length of hospital stay and number of admissions for the 2-year periods before and after initiation of AST-120 treatment were calculated.

Results: Results of renal function tests, atrial natriuretic peptide, edema, cardiothoracic ratio and hospital stay indicated significant improvements in patients treated with AST-120. The length of hospital stay and number of admissions both decreased significantly during the 2 years of AST-120 treatment compared with the 2 years before treatment, from 39.7 ± 12.9 days to 4.14 ± 2.5 days, and from 0.79 ± 0.21 admissions to 0.21 ± 0.11 admissions, respectively.

Conclusions: AST-120 contributes to the improvement of cardiac and renal functions, and consequently improves the quality of life of patients.

MeSH terms

  • Aged
  • Carbon / therapeutic use*
  • Chronic Disease
  • Female
  • Heart Failure / drug therapy*
  • Heart Failure / psychology
  • Humans
  • Kidney Diseases / complications
  • Kidney Diseases / drug therapy*
  • Male
  • Middle Aged
  • Oxides / therapeutic use*
  • Protective Agents / therapeutic use*
  • Quality of Life


  • Oxides
  • Protective Agents
  • Carbon
  • AST 120