| [ Summary ] |
Since the administration of oral adsorbent (AST-120 ; Kremezin(R)) delayed the progression of chronic renal failure (CRF), circulating uremic toxins are thought to be involved in the progression of CRF. We demonstrated the following evidence. 1) There was a marked elevation of the serum levels of indoxyl sulfate, a dietary protein metabolite, in 5/6-nephrectomized uremic rats and in uremic patients, 2) Oral administration of indoxyl sulfate to uremic rats enhanced the renal expression of TGF-beta1, leading to the progression of CRF, 3) Oral administration of AST-120 reduced the serum levels of indoxyl sulfate and suppressed the renal expression of TGF-beta1 in uremic rats, resulting in the suppression of the CRF progression, 4) Patients who showed a greater decrease in urinary indoxyl sulfate by AST-120 showed more marked suppression of the progression of CRF. In conclusion, indoxyl sulfate is a uremic toxin promoting the progression of CRF. |