Ps-c09-13: new comprehensive therapeutic strategy for hypertension and uremia using inorganic substances with special adsorption properties

Background: In order to remove uremic toxins accumulated in patients with chronic kidney disease (CKD), removal of uremic toxin-causing substances from the intestinal tract by administration of spherical adsorbed charcoal and removal of uremic toxins from the blood by hemodialysis are being performed. However, existing treatment methods are still inadequate for the removal of protein-bound uremic toxins (PBUT) and other medium- to large-sized uremic toxins, which leads to a decreased quality of life and worse prognosis in CKD patients. In order to solve this remaining problem, we are currently investigating the use of inorganic materials for the treatment of uremia. Methods: To evaluate the adsorption performance of our inorganic material, we compared the adsorption performance of various uremic substances in solution, healthy subjects’ plasma, and hemodialysis patients’ plasma, using Kremezin® as a control. Results: Kremezin® was able to adsorb small molecular weight substances in each solution and plasma, while medium to large molecules were poorly adsorbed. On the other hand, the inorganic material we are developing has high adsorption performance not only for small molecules but also for medium to large molecules including inflammatory cytokines and PBUT, and selectively adsorbs cations such as sodium, potassium, and inorganic phosphorus. Conclusion: Inorganic substances with special adsorption performance adsorbed not only uremic substances but also cations, whose accumulation is a problem in CKD patients. Therefore, the inorganic adsorbent may contribute not only to the treatment of uremia but also to the comprehensive treatment of hypertension, hyperkalemia, and CKD-MBD, which are common complications in CKD patients.