- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe, Kineret (anakinra) / SOBI
Journal: Uremic Toxins, Chronic Kidney Disease, and Cognitive Dysfunction. (Pubmed Central) - Feb 26, 2025
Finally, future research directions are suggested including targeting of cellular senescence abundance with senotherapeutics and capitalizing on anti-inflammatory effects of regenerative, cell-based therapeutics (e.g. mesenchymal stem cells and extracellular vesicles), and use of aged murine models. Collectively, CKD-associated cognitive impairment represents a prevalent condition for which remaining knowledge gaps exist, and scientific advancements are needed to preserve cognitive function and improve the lives of in individuals with CKD.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe, MitoQ (mitoquinone) / Antipodean, sirolimus / Generic mfg.
Journal: Mitochondrial dysfunction and mitophagy blockade contribute to renal osteodystrophy in chronic kidney disease-mineral bone disorder. (Pubmed Central) - Feb 9, 2025
A causal link between uremic toxins and the development of mitochondrial abnormalities and ROD was established by showing that a mitochondria-targeted antioxidant (MitoQ) and the charcoal adsorbent AST-120 were able to mitigate the uremic toxin-induced mitochondrial changes and improve bone health...Targeting uremic toxins, oxygen-free radical production and the mitophagy process may offer novel routes for intervention to preserve bone health in patients with CKD-MBD. This would be timely as our current armamentarium of anti-fracture medications for patients with severe CKD-MBD is limited.
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Journal: A case of chronic kidney disease with refractory periodic vomiting and hypertension in a pediatric patient. (Pubmed Central) - Feb 1, 2025
In Japan, the uremic toxin adsorbent AST-120 and angiotensin-converting enzyme inhibitor-I (ACE-I) are not strongly recommended for CKD patients...However, our patient had low serum levels of proinflammatory cytokines, and his serum levels of the chemokines CX3CL1 and CCL2 decreased with age, together with improvement in his clinical course. Therefore, some specific chemokines might be diagnostic and/or prognostic biomarkers of CKD.
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Effect of Oral Absorbent Therapy on Kidney Progression According to the Cause of CKD (Exhibit Hall, Convention Center) - Sep 23, 2024 - Abstract #KIDNEYWEEK2024KIDNEY_WEEK_3479;
Our findings demonstrate the potential therapeutic effects of AST-120 in lowering IS levels and improving cognitive and emotional impairments associated with CKD. Changes in Serum Cr Before and After Drug Therapy Over One Year in Each Etiology Group Background: Oral absorbent therapy with DW-7202 (Renemezin
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Journal: Electrospun EVOH/AST-120 hybrid nanofiber membranes for removal of indoxyl sulfate from blood. (Pubmed Central) - Aug 23, 2024
Furthermore, the nanofibers successfully reduced the IS concentration in the blood under circulating conditions. Therefore, these EVOH/AST-120 nanofibers are expected to greatly improve the prognosis of patients with CKD when used in combination with the current hemodialysis therapy as an IS-adsorbing filter.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Plasmablastic Lymphoma in the Duodenum: A Rare and Aggressive disease (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_3788;
He was found to be intermittently febrile, and initial laboratory studies were significant for WBC 1.82 K/?L, Hb 6.0 g/dL, platelets 41 K/?L, alkaline phosphatase 603 U/L, AST 120 U/L, ALT 62 U/L, total bilirubin 0.8 mg/dL, CD4 98 cells/?L, and HIV viral load 2,700,455...Figure 2 (right) reveals Endoscopic findings on initial EGD of near-obstructing mass in duodenal sweep and 2nd portion of duodenum. Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
A Challenging Diagnosis of Low-grade Appendiceal Mucinous Neoplasm Mimicking Ovarian Cancer and Primary Biliary Cholangitis (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_3763;
Labs showed WBC 12.8 k/mm3, lactic acid 2.4 mmol/l, creatinine 5.43 mg/dl (baseline 0.7 mg/dl), AST 120 iu/l, ALT 58 u/l, alkaline phosphatase 468 u/l, and total bilirubin 6.7 mg/dl...Additionally, colorectal cancer should be excluded with a colonoscopy in these patients due to the associated risks. Figure: A. Magnetic Resonance Imaging of the Abdomen and Pelvis without contrast showing moderate to large amounts of abdominal ascites.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe, Lenvima (lenvatinib) / Eisai, Merck (MSD)
Now You See Me, Now You Don't: Spontaneous Remission of HCC (Exhibit Hall E) - Aug 20, 2024 - Abstract #ACG2024ACG_1761;
Labs were notable for chronic HBV co-infection with Hepatitis D, HBV viral load of 60 IU/mL, ALT 91 U/L, AST 120 U/L, total bilirubin 1.4 mg/dL, AFP of 1429 ng/mL...He was referred to medical oncology, who recommended lenvatinib for treatment of unresectable HCC...During this interval, he was started on entecavir 0.5 mg daily for treatment of chronic HBV...MRI abdomen in 11/2017 demonstrated a 93 mm, ill-defined heterogenous mass involving the right lobe of the liver, predominantly in segment 5, 6 and 8 (A). By 12/2018, this mass was no longer recognized (B), and remained as such in 12/2019 (C) and on most recent imaging in 11/2023 (D).
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Journal: Pharmacologic therapeutics in sarcopenia with chronic kidney disease. (Pubmed Central) - Feb 23, 2024
AST-120 prevented IS and PCA tissue accumulation, ameliorated muscle atrophy, improved exercise capacity and mitochondrial biogenesis, restored epithelial tight junction proteins, and reduced plasma endotoxin levels and markers of oxidative stress and inflammation. In a human study, the addition of AST-120 to standard treatment had modest beneficial effects on gait speed change and quality of life.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Trial completion, Phase classification, Enrollment change: AST-120 in Hemodialysis Patients With Uremic Pruritus (clinicaltrials.gov) - Sep 7, 2023
P4, N=100, Completed,
AST-120 administration may serve as a potential therapeutic strategy. Recruiting --> Completed | Phase classification: PN/A --> P4 | N=150 --> 100
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Optimal Dosage of Kremezin in CKD (Room 4) - May 2, 2023 - Abstract #KSN2023KSN_429;
Spyglass cholangioscopy: Erythematous biliary mucosa. Sponsored by HK Inno.N
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe, Sarconeos (BIO101) / Biophytis, bimagrumab (BYM338) / Novartis, MorphoSys, Versanis Bio
Effect of Pharmacologic Therapeutics in Sarcopenic Patients with Chronic Kidney Disease (Room 5) - Apr 15, 2023 - Abstract #KSN2023KSN_29;
These conditions inducethe activation of NF-kB and MAPK pathway, ATP-UPS, and ROS system, resulting in the proteincatabolism (decreased protein synthesis and increased protein degradation).There have been many drugs which were developed to prevent or treat sarcopenia (general).However, only a few of them, i.e., Bimagrumab from Novartis and Sarconeos from Biophytis SAS,reported recent results and showed the effectiveness in terms of adiposity, metabolic disturbances,and walking test in limited criteria of participants in 2021 and 2022.The main interventions for prevention and treatment of sarcopenia in Chronic kidney disease (CKD)are aerobic and resistance exercises along with nutritional interventions...Reduced exercise capacity, decreased PGC-1?,increased mitochondrial autophagy was restored by AST-120. AST-120 restored the epithelial tightjunction proteins and reduced plasma endotoxin and markers of oxidative stress and inflammation.AST-120 administration also changed overall gut microbiota composition in the CKD model.In a human study, the addition of AST-120 to standard treatment modestly had beneficial effects ongait speed change and quality of life and showed the potential to improve sarcopenia.Prospective studies with longer follow-up duration, larger sample size, and interventions of uremictoxin lowering are necessary to elucidate the role of uremic toxin in sarcopenia in CKD patients.
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Journal: The G protein-coupled receptor ligand apelin-13 ameliorates skeletal muscle atrophy induced by chronic kidney disease. (Pubmed Central) - Dec 24, 2022
AST-120 restored the epithelial tightjunction proteins and reduced plasma endotoxin and markers of oxidative stress and inflammation.AST-120 administration also changed overall gut microbiota composition in the CKD model.In a human study, the addition of AST-120 to standard treatment modestly had beneficial effects ongait speed change and quality of life and showed the potential to improve sarcopenia.Prospective studies with longer follow-up duration, larger sample size, and interventions of uremictoxin lowering are necessary to elucidate the role of uremic toxin in sarcopenia in CKD patients. This study demonstrated for the first time the association of the Apj endogenous ligand-uraemic toxin axis with skeletal muscle atrophy in CKD and the utility of therapeutic targeting of the apelin-Apj system.
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Autoimmune Hepatitis After COVID-19 Vaccine: An Unusual Complication (Crown Ballroom) - Sep 4, 2022 - Abstract #ACG2022ACG_3414;
In June of 2021, about two weeks after the second dose, the patient was found with AST 120 u/L, ALT 181 u/L, Platelets 90...Patient was started on steroids in November 2021, and later, azathioprine, with improvement of liver enzymes...Given the serious implications of this disease and the number of vaccines against COVID-19 given world-wide, further research is needed to better understand this entity and its pathophysiology. Table: Lab Values
- |||||||||| Ravicti (glycerol phenylbutyrate) / Horizon Therapeutics, Immedica, Kremezin (AST-120) / Mitsubishi Tanabe, Xifaxan (rifaximin) / Alfa Wassermann, Bausch Health, Norgine, ASKA Pharma
Review, Journal: Novel Drugs for the Management of Hepatic Encephalopathy: Still a Long Journey to Travel. (Pubmed Central) - Jul 12, 2022
However, their clinical use is limited due to the presence of major drawbacks in their study design, sample size, safety profile, bias, and heterogenicity. This study will discuss the novel therapeutic targets for HE in liver cirrhosis patients with supporting clinical trial data.
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Trial completion date, Trial primary completion date: AST-120 in Hemodialysis Patients With Uremic Pruritus (clinicaltrials.gov) - Jun 6, 2022
P=N/A, N=150, Recruiting,
This study will discuss the novel therapeutic targets for HE in liver cirrhosis patients with supporting clinical trial data. Trial completion date: Dec 2021 --> Aug 2022 | Trial primary completion date: Jun 2021 --> Aug 2022
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Preclinical, Journal: The Effects of Sacran, a Sulfated Polysaccharide, on Gut Microbiota Using Chronic Kidney Disease Model Rats. (Pubmed Central) - May 9, 2022
The 5/6 nephrectomy rats were also divided into three groups: sacran treated, non-treated and AST-120 treated groups, and treated orally in a concentration-dependent manner for 4 weeks...The changes in the intestinal microflora of the sacran treated group were positively correlated with an increase in the number of Lactobacillus species, which are known to be rich in beneficial bacteria, and the increment of this beneficial bacteria was negatively correlated with the concentration of indoxyl sulfate, a uremic toxin, in plasma. These results strongly suggest that the oral administration of sacran could contribute to the stabilization of intestinal microflora in CKD rats and to the reduction of oxidative stress as well as the inhibition of progression of CKD.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Preclinical, Journal: Vascular Endothelial Dysfunction in the Thoracic Aorta of Rats with Ischemic Acute Kidney Injury: Contribution of Indoxyl Sulfate. (Pubmed Central) - Mar 25, 2022
Next, we administered AST-120, a spherical adsorbent charcoal, after reperfusion to assess whether the vascular endothelial dysfunction associated with the ischemic AKI was due to a temporary increase in blood IS levels...Thus, in ischemic AKI, we confirmed that the vascular endothelial function of the thoracic aorta is impaired even after the recovery of kidney injury, probably with excessive ROS production. IS, which increases from ischemia to early after reperfusion, may not be a major contributor to the vascular dysfunction associated with ischemic AKI.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Journal: Novel intestinal dialysis interventions and microbiome modulation to control uremia. (Pubmed Central) - Feb 1, 2022
There is a clear need for further research in this field. Interventions aimed at enhancing bowel elimination of uremic toxins, fluid and electrolytes and at modulating gut microbiota may represent novel therapeutic strategies for the management of uremia in patients with CKD.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Review, Journal: The Therapeutic Strategies for Uremic Toxins Control in Chronic Kidney Disease. (Pubmed Central) - Jan 27, 2022
The effects of medications such as AST-120 and meclofenamate are described...The research status of Chinese herbal medicine is discussed for CAM and other therapies. This review can provide some treatment recommendations for the reduction of UTs in patients with chronic kidney disease.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Journal: Early Elimination of Uremic Toxin Ameliorates AKI to CKD Transition. (Pubmed Central) - Dec 18, 2021
Our results demonstrated IS potentiates renal fibrosis, senescence-associated secretory phenotype (SASP), and activation of endoplasmic reticulum (ER) stress, which is attenuated by synergistic AST-120 administration...Finally, the ER chemical chaperon, 4-PBA, successfully reversed the above-mentioned AKI to CKD transition. Taken together, early IS elimination in the early stage of AKI is likely to be a useful strategy in the prevention or treatment of the AKI to CKD transition.
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Preclinical, Journal: Indoxyl sulfate caused behavioral abnormality and neurodegeneration in mice with unilateral nephrectomy. (Pubmed Central) - Jul 28, 2021
Intriguingly, intracerebroventricular indoxyl sulfate administration only caused limited alterations in the normal mice and the alterations were reversed by aryl hydrocarbon receptor antagonism. The findings suggest pathogenic roles of indoxyl sulfate in the development of CNS diseases, and highlight gut microbiota as alternative targets for intervention with the aim of slowing down the progression of CKD and decreasing CNS complications.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Review, Journal: Indoxyl Sulfate, a Tubular Toxin, Contributes to the Development of Chronic Kidney Disease. (Pubmed Central) - Jul 10, 2021
The poor removal of serum IS in conventional hemodialysis is also significantly associated with all-cause mortality and heart failure incidence in end-stage renal disease patients. Scavenging the IS precursor by AST-120 can markedly reduce tubular IS staining that attenuates renal tubular injury, ameliorates IS-induced oxidative stress and rescues antioxidant glutathione activity in tubular epithelial cells, thereby providing a protective role against tubular injury and ultimately retarding renal function decline.
- |||||||||| Kremezin (AST-120) / Mitsubishi Tanabe
Review, Journal: Indoxyl-Sulfate-Induced Redox Imbalance in Chronic Kidney Disease. (Pubmed Central) - Jul 4, 2021
This review summarizes the underlying mechanisms of how IS mediates oxidative stress in the pathogenesis of CKD's complications. Furthermore, we also discuss the potential role of oral AST-120 in attenuating IS-mediated oxidative stress after gastrointestinal adsorption of the IS precursor indole.
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