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Efficacy of AST-120 in Preventing the Progression of Chronic Kidney Disease: A Meta-analysis
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  • Vernon Chuabio,
  • Ron Castillo,
  • Jereel Sahagun,
  • Rey Jaime Tan
Vernon Chuabio
Philippine General Hospital
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Ron Castillo
Philippine General Hospital
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Jereel Sahagun
Philippine General Hospital
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Rey Jaime Tan
Philippine General Hospital
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Abstract

Chronic kidney disease (CKD) is a major cause of disease burden globally. With end-stage renal disease (ESRD), renal replacement therapy via dialysis or kidney transplant can be economically costly. This meta-analysis evaluated the efficacy of AST-120, an oral adsorbent marketed to be able to delay progression of CKD. Outcomes assessed included mortality, ESRD incidence, and doubling of serum creatinine. Databases including Cochrane, PubMed, and Clinicaltrials.gov were searched, and literature-mining from prior publications was also done, yielding a total of 50 non-duplicate citations. Further screening for appropriateness yielded 5 studies included in this meta-analysis. Regarding the effect of AST-120 on all-cause mortality among CKD patients, the pooled data showed a total of 110 events out of 1503 subjects in the interventional group and 116 events out of 1494 subjects in the control group, giving a risk ratio (RR) with 95% confidence interval (CI) of 0.94 [0.74, 1.21]. On the outcome of ESRD incidence, a total of 353 events out of 1524 subjects in the interventional group and 374 events out of 1517 subjects in the control group yielded a RR with 95% CI of 0.94 [0.83, 1.07]. Regarding doubling of serum creatinine, 155 events in both the interventional and control groups, which had 1503 and 1494 subjects, respectively, gave a RR with 95% CI of 0.99 [0.80, 1.22]. In conclusion, AST-120 has no significant clinical benefit over standard treatment in delaying CKD progression. Further studies examining different dosages of AST-120 and its effect on different CKD stages are recommended.