Effects and safety of an oral adsorbent on chronic kidney disease progression: A systematic review and meta-analysis

Ying Chun Chen, Mei Yi Wu, Ping Jen Hu, Tzu Ting Chen, Wan Chen Shen, Wei Chiao Chang, Mai Szu Wu

Research output: Contribution to journalArticlepeer-review

21 Citations (Scopus)


Background: AST-120 (Kremezin), which is an oral spherical carbon adsorbent, has been reported to have the potential for retarding disease progression in patients with chronic kidney disease. We aimed to evaluate its efficacy and safety in this study. Methods: We systematically searched for randomized controlled trials published in PubMed, Embase, and Cochrane databases. The primary outcomes were the renal outcome and all-cause mortality, and the change in serum indoxyl sulfate (IS) levels. The safety outcome was also evaluated in terms of reported major adverse events. A random-effects model was used when heterogeneity was expected. Results: Eight studies providing data for 3349 patients were included in the meta-analysis. The risk ratio of renal outcome and all-cause mortality were 0.97 (95% CI: 0.88–1.07; 6 trials) and 0.94 (0.73–1.20; 5 trials), respectively. Furthermore, the weighted mean change in IS levels from baseline to the end of the study was −0.28 mg/dL (95% CI: −0.46 to −0.11; 4 trials). Conclusions: This study provides evidence that AST-120 can effectively lower IS levels but still controversial in terms of slowing disease progression and all-cause mortality. Except for dermatological events, the incidence of adverse events did not differ significantly between the AST-120 and placebo groups.

Original languageEnglish
Article number1718
JournalJournal of Clinical Medicine
Issue number10
Publication statusPublished - Oct 2019


  • AST-120
  • Chronic kidney disease
  • Kremezin
  • Meta-analysis
  • Systematic review

ASJC Scopus subject areas

  • Medicine(all)


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