Altunkaynak Hande O, Karaismailoglu Eda, Massy Ziad A
Department of Pharmacology, Gulhane Faculty of Pharmacy, University of Health Sciences, 06018 Ankara, Turkey.
Department of Medical Informatics, Gulhane Faculty of Medicine, University of Health Sciences, 06018 Ankara, Turkey.
Toxins (Basel). 2024 Dec 16;16(12):544. doi: 10.3390/toxins16120544.
The therapeutic benefit of the oral adsorbent drug AST-120 in chronic kidney disease (CKD) is related to an indoxyl sulfate (IS)-lowering action. Diabetes and dyslipidemia might worsen kidney damage in CKD. However, it is not known whether AST-120 influences lipid abnormalities as well as renal function in patients with CKD and diabetes. The objective of the present meta-analysis was to evaluate the efficacy of AST-120 treatment in CKD using data from preclinical studies. Mixed-effect or random-effect models were used to estimate the standardized mean difference (SMD) and the 95% confidence interval (CI). Publication bias was assessed with a funnel plot and Egger's test. The potential influence of some variables (the dose and duration of AST-120 treatment, the animal species, and the CKD model's diabetic status) was evaluated in subgroup analyses. Treatment with AST-120 was associated with a significantly lower IS level in animals with CKD (SMD = -1.75; 95% CI = -2.00, -1.49; < 0.001). Significant improvements in markers of renal function and the lipid profile were also observed. In subgroup analyses of the cholesterol level, the diabetic status, the AST-120 dose, and the animal species were found to be influential factors. AST-120 lowered serum IS and triglyceride levels and improved renal function in animal models of CKD independent of diabetes status. However, AST-120's ability to lower the total cholesterol level was more prominent in animals with diabetic CKD.
口服吸附剂药物AST - 120对慢性肾脏病（CKD）的治疗益处与降低硫酸吲哚酚（IS）的作用有关。糖尿病和血脂异常可能会加重CKD患者的肾损伤。然而，尚不清楚AST - 120是否会影响CKD合并糖尿病患者的脂质异常及肾功能。本荟萃分析的目的是利用临床前研究数据评估AST - 120治疗CKD的疗效。采用混合效应或随机效应模型估计标准化均数差（SMD）和95%置信区间（CI）。通过漏斗图和Egger检验评估发表偏倚。在亚组分析中评估了一些变量（AST - 120治疗的剂量和持续时间、动物种类以及CKD模型的糖尿病状态）的潜在影响。在患有CKD的动物中，AST - 120治疗与显著降低的IS水平相关（SMD = - 1.75；95% CI = - 2.00，- 1.49；P < 0.001）。还观察到肾功能标志物和脂质谱有显著改善。在胆固醇水平的亚组分析中，发现糖尿病状态、AST - 120剂量和动物种类是影响因素。AST - 120可降低CKD动物模型的血清IS和甘油三酯水平，并改善肾功能，且与糖尿病状态无关。然而，AST - 120降低总胆固醇水平的能力在糖尿病CKD动物中更为突出。
