Effects of AST‐120 on muscle health and quality of life in chronic kidney disease patients: results of RECOVERY study
Abstract Background The prevalence of sarcopenia is increased with declining renal function. Elevated serum indoxyl sulfate levels are associated with poor skeletal muscle conditions. We aimed to determine the effects of AST‐120, the oral adsorbent of indoxyl sulfate, on sarcopenia and sarcopenia‐as...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-02-01
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| Series: | Journal of Cachexia, Sarcopenia and Muscle |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jcsm.12874 |
| _version_ | 1797826784193937408 |
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| author | Ran‐hui Cha Seok Hui Kang Mi Yeun Han Won Suk An Su‐Hyun Kim Jun Chul Kim |
| author_facet | Ran‐hui Cha Seok Hui Kang Mi Yeun Han Won Suk An Su‐Hyun Kim Jun Chul Kim |
| author_sort | Ran‐hui Cha |
| collection | DOAJ |
| description | Abstract Background The prevalence of sarcopenia is increased with declining renal function. Elevated serum indoxyl sulfate levels are associated with poor skeletal muscle conditions. We aimed to determine the effects of AST‐120, the oral adsorbent of indoxyl sulfate, on sarcopenia and sarcopenia‐associated factors in chronic kidney disease patients. Methods This was a 48 week, randomized controlled, parallel group, open‐label, multicentre trial (n = 150). The participants were randomly assigned in a 1:1 ratio to the control (CON) and AST‐120 (Renamezin®, REN) groups. Outcome measurements were performed at baseline and every 24 weeks for 48 weeks. The primary outcome was gait speed difference ≥0.1 m/s between the two groups, and secondary outcomes included hand grip strength, muscle mass, and health‐related quality of life. Results A difference of gait speed ≥0.1 m/s was not observed during the study period. The mean dynamic‐start gait speed in the REN group increased from baseline to 48 weeks (1.04 ± 0.31 to 1.08 ± 0.32 m/s, P = 0.019). The static‐start gait speed changed by −0.024 and 0.04 m/s (P = 0.049) in the CON and REN groups over 48 weeks, respectively. Hand grip strength decreased during the first 24 weeks and did not significantly change over the next 24 weeks in either group. The proportion of low muscle mass or sarcopenia at baseline was larger in the REN group than in the CON group, but the difference attenuated over the study period [low muscle mass and sarcopenia in the CON and REN groups at baseline, 4.0% vs. 18.9% (P = 0.004) and 2.7% vs. 13.5% (P = 0.017); at 24 weeks, 2.9% vs. 13.6% (P = 0.021) and 1.4% vs. 10.5% (P = 0.029); and at 48 weeks, 7.6% vs. 12.9% (P = 0.319) and 4.5% vs. 8.1% (P = 0.482), respectively]. Bodily pain, vitality, symptoms/problems, and cognitive function in the REN group improved, while the quality of social interactions and the kidney disease effects in the CON group aggravated from baseline to 48 weeks. Interaction between time and group was evident only in symptoms/problems, cognitive function, and kidney disease effects. Conclusions The addition of AST‐120 to standard treatment in chronic kidney disease patients did not make a significant difference in gait speed, although AST‐120 modestly had beneficial effects on gait speed change and quality of life and showed the potential to improve sarcopenia. (clinicaltrials.gov: NCT03788252). |
| first_indexed | 2024-04-09T12:37:46Z |
| format | Article |
| id | doaj.art-93da7b714fcb4bd4891d7d870fb8dfdc |
| institution | Directory Open Access Journal |
| issn | 2190-5991 2190-6009 |
| language | English |
| last_indexed | 2024-04-09T12:37:46Z |
| publishDate | 2022-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Cachexia, Sarcopenia and Muscle |
| spelling | doaj.art-93da7b714fcb4bd4891d7d870fb8dfdc2023-05-15T09:27:15ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092022-02-0113139740810.1002/jcsm.12874Effects of AST‐120 on muscle health and quality of life in chronic kidney disease patients: results of RECOVERY studyRan‐hui Cha0Seok Hui Kang1Mi Yeun Han2Won Suk An3Su‐Hyun Kim4Jun Chul Kim5Department of Internal Medicine National Medical Center Seoul Republic of KoreaDepartment of Internal Medicine Yeungnam University College of Medicine Daegu Republic of KoreaDepartment of Internal Medicine Hallym University Hangang Sacred Heart Hospital Seoul Republic of KoreaDepartment of Internal Medicine Dong‐A University College of Medicine Busan Republic of KoreaDepartment of Internal Medicine Chung‐Ang University Hospital, Chung‐Ang University College of Medicine Seoul Republic of KoreaDepartment of Internal Medicine, CHA Gumi Medical Center CHA University Gumi Republic of KoreaAbstract Background The prevalence of sarcopenia is increased with declining renal function. Elevated serum indoxyl sulfate levels are associated with poor skeletal muscle conditions. We aimed to determine the effects of AST‐120, the oral adsorbent of indoxyl sulfate, on sarcopenia and sarcopenia‐associated factors in chronic kidney disease patients. Methods This was a 48 week, randomized controlled, parallel group, open‐label, multicentre trial (n = 150). The participants were randomly assigned in a 1:1 ratio to the control (CON) and AST‐120 (Renamezin®, REN) groups. Outcome measurements were performed at baseline and every 24 weeks for 48 weeks. The primary outcome was gait speed difference ≥0.1 m/s between the two groups, and secondary outcomes included hand grip strength, muscle mass, and health‐related quality of life. Results A difference of gait speed ≥0.1 m/s was not observed during the study period. The mean dynamic‐start gait speed in the REN group increased from baseline to 48 weeks (1.04 ± 0.31 to 1.08 ± 0.32 m/s, P = 0.019). The static‐start gait speed changed by −0.024 and 0.04 m/s (P = 0.049) in the CON and REN groups over 48 weeks, respectively. Hand grip strength decreased during the first 24 weeks and did not significantly change over the next 24 weeks in either group. The proportion of low muscle mass or sarcopenia at baseline was larger in the REN group than in the CON group, but the difference attenuated over the study period [low muscle mass and sarcopenia in the CON and REN groups at baseline, 4.0% vs. 18.9% (P = 0.004) and 2.7% vs. 13.5% (P = 0.017); at 24 weeks, 2.9% vs. 13.6% (P = 0.021) and 1.4% vs. 10.5% (P = 0.029); and at 48 weeks, 7.6% vs. 12.9% (P = 0.319) and 4.5% vs. 8.1% (P = 0.482), respectively]. Bodily pain, vitality, symptoms/problems, and cognitive function in the REN group improved, while the quality of social interactions and the kidney disease effects in the CON group aggravated from baseline to 48 weeks. Interaction between time and group was evident only in symptoms/problems, cognitive function, and kidney disease effects. Conclusions The addition of AST‐120 to standard treatment in chronic kidney disease patients did not make a significant difference in gait speed, although AST‐120 modestly had beneficial effects on gait speed change and quality of life and showed the potential to improve sarcopenia. (clinicaltrials.gov: NCT03788252).https://doi.org/10.1002/jcsm.12874AST‐120Chronic kidney diseaseGait speedHandgrip strengthQuality of lifeSarcopenia |
| spellingShingle | Ran‐hui Cha Seok Hui Kang Mi Yeun Han Won Suk An Su‐Hyun Kim Jun Chul Kim Effects of AST‐120 on muscle health and quality of life in chronic kidney disease patients: results of RECOVERY study Journal of Cachexia, Sarcopenia and Muscle AST‐120 Chronic kidney disease Gait speed Handgrip strength Quality of life Sarcopenia |
| title | Effects of AST‐120 on muscle health and quality of life in chronic kidney disease patients: results of RECOVERY study |
| title_full | Effects of AST‐120 on muscle health and quality of life in chronic kidney disease patients: results of RECOVERY study |
| title_fullStr | Effects of AST‐120 on muscle health and quality of life in chronic kidney disease patients: results of RECOVERY study |
| title_full_unstemmed | Effects of AST‐120 on muscle health and quality of life in chronic kidney disease patients: results of RECOVERY study |
| title_short | Effects of AST‐120 on muscle health and quality of life in chronic kidney disease patients: results of RECOVERY study |
| title_sort | effects of ast 120 on muscle health and quality of life in chronic kidney disease patients results of recovery study |
| topic | AST‐120 Chronic kidney disease Gait speed Handgrip strength Quality of life Sarcopenia |
| url | https://doi.org/10.1002/jcsm.12874 |
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