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Uremic Toxins and Oral Adsorbents
Author(s) -
Goto Shunsuke,
Yoshiya Kunihiko,
Kita Tomoyuki,
Fujii Hideki,
Fukagawa Masafumi
Publication year - 2011
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2010.00891.x
Subject(s) - medicine , uremic toxins , sevelamer , in vivo , uremia , pharmacology , dialysis , hyperphosphatemia , hemodialysis , kidney disease , biology , microbiology and biotechnology
Uremic toxins are associated with various disorders in patients with end‐stage renal disease and it is difficult to remove some of these toxins by dialysis. Since some uremic toxins are generated by bacterial metabolites in the colon, oral adsorbents that interfere with the absorption of uremic toxins or their precursors are believed to prevent their accumulation in the body. AST‐120 adsorbs various uremic retention solutes in the gastrointestinal system and has potential for providing clinical benefit. Sevelamer hydrochloride binds some harmful compounds in addition to phosphate and seems to have pleiotropic effects that include lowering serum LDL cholesterol levels and reduction of inflammation. The effect of sevelamer hydrochloride on indoxyl sulfate and p ‐cresol has been shown in an in vitro study; however, in vivo studies in mice or humans did not demonstrate this effect on protein‐binding uremic toxins. Oral adsorbents are thus one of the important modalities in the treatment of uremic syndrome.