Oral Sorbent Suppresses Accumulation of Albumin-Bound Indoxyl Sulphate in Serum of Haemodialysis Patients

Abstract

Serum indoxyl sulphate, which is markedly accumulated in haemodialysis patients, cannot be removed efficiently by haemodialysis due to its albumin-binding property. To determine whether an oral adsorbent (AST-120) can decrease its serum concentration, AST-120 was administered to haemodialysis patients. The patients given AST-120 showed significantly reduced serum concentration of indoxyl sulphate as compared to control haemodialysis patients, even though the serum concentrations of urea nitrogen and creatinine did not decrease significantly in the patients treated with AST-120. The haemodialysis patients with generalised pruritus showed an amelioration of itching after administration of AST-120. These results showed that AST-120 was effective in reducing the serum concentration of albumin-bound indoxyl sulphate in haemodialysis patients by adsorption of indole, a precursor of indoxyl sulphate, in the intestines, and that it relieved itching in haemodialysis patients with generalised pruritus.