Shin Dong Hui, Park Keunryul, Yang Jae Won, Lee Jun Young
Department of Nephrology, Comprehensive Kidney Disease Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea.
Int J Environ Res Public Health. 2025 Aug 30;22(9):1365. doi: 10.3390/ijerph22091365.
Spherical Adsorptive Carbon (SAC), a type of oral sorbent, is prescribed to chronic kidney disease (CKD) patients to remove uremic toxins. However, evidence regarding its effectiveness in delaying chronic kidney disease (CKD) progression remains insufficient. We aimed to evaluate the impact of SAC on CKD progression in patients with CKD stage 3 or higher using nationwide data. In this retrospective cohort study, we included patients diagnosed with CKD stage ≥3 from the Korea National Health Insurance System database between January 2020 and December 2022. Outcomes were compared between SAC users (N = 1289) and non-users (N = 1289) after 1:1 propensity score matching (PSM). After PSM, the time from index date to end-stage kidney disease (ESKD) was significantly longer in the SAC user group compared to the non-user group (246.8 days vs. 118.6 days, < 0.001). In Cox regression analysis, the risk of ESKD was significantly lower in the SAC group (HR = 0.37, 95% CI: 0.29-0.48). However, the risk of dialysis initiation did not show a significant difference between the two groups (HR = 0.83, 95% CI: 0.27-2.59). This nationwide cohort study suggests that SAC treatment may delay progression from CKD stage 3 to ESKD, although it did not significantly reduce the risk of dialysis initiation.
球形吸附碳（SAC）是一种口服吸附剂，被用于慢性肾脏病（CKD）患者以清除尿毒症毒素。然而，关于其延缓慢性肾脏病（CKD）进展有效性的证据仍然不足。我们旨在利用全国性数据评估SAC对3期及以上CKD患者CKD进展的影响。在这项回顾性队列研究中，我们纳入了2020年1月至2022年12月期间韩国国民健康保险系统数据库中诊断为CKD≥3期的患者。在1:1倾向评分匹配（PSM）后，比较了SAC使用者（N = 1289）和非使用者（N = 1289）的结局。PSM后，SAC使用者组从索引日期到终末期肾病（ESKD）的时间明显长于非使用者组（246.8天对118.6天，<0.001）。在Cox回归分析中，SAC组ESKD的风险显著更低（HR = 0.37，95%CI：0.29 - 0.48）。然而，两组之间透析开始的风险没有显著差异（HR = 0.83，95%CI：0.27 - 2.59）。这项全国性队列研究表明，SAC治疗可能会延缓从CKD 3期到ESKD的进展，尽管它并没有显著降低透析开始的风险。
