Kremezin, AST-120

Uremic Toxins

Uremic syndrome results from a malfunctioning of various organ systems due to the retention of compounds which, under normal conditions, would be excreted into the urine and/or metabolized by the kidneys. If these compounds are biologically active, they are called uremic toxins. One of the more important toxic effects of such compounds is cardio-vascular damage.5

Kremezin (AST-120) is an oral adsorbent that slows down the progression of chronic renal failure (CRF) by removing uremic toxins. This spherical carbonaceous adsorbent is composed of microcrystalline carbon with oxygen including surface oxides. It acts as surfactant and gastrointestinal agent.

Use of Kremezin

The oral adsorbent, AST-120 (Kremezin), can delay the progression of chronic renal failure in undialyzed patients with uremic syndrome.6

Recent studies show that Kremezin may have therapeutic potentials for the treatment of patients with various advanced glycation end products-related disorders such as diabetic microangiopathy, ischemic heart disease and neurodegenerative diseases.1 This orally administered adsorbent shows adsorption ability superior to activated charcoal for certain organic compounds that accumulate in patients with chronic kidney disease (CKD) and that are believed to accelerate the decline in kidney function.2

A low-protein diet and treatment with renin-angiotensin system (RAS) blockers can delay the progression of chronic kidney disease (CKD). The oral adsorbent Kremezin has a kidney protective effect by reducing serum levels of uremic toxins, especially in patients with early or rapid progression.3

A number of clinical studies have proven that Kremesin (AST-120) is useful for the control of intractable anal fistulas in Crohn's disease patients. Kremesin treatment is well tolerated and no life-threatening adverse events are observed.4


  1. Oral administration of AST-120 (Kremezin) is a promising therapeutic strategy for advanced glycation end product (AGE)-related disorders. In: Med Hypotheses. 2007;69(3):666-8. Epub 2007 Feb 28.
  2. A multicenter, randomized, double-blind, placebo-controlled, dose-ranging study of AST-120 (Kremezin) in patients with moderate to severe CKD. Schulman G, Agarwal R, Acharya M, Berl T, Blumenthal S, Kopyt N. In: Am J Kidney Dis. 2006 Apr;47(4):565-77.
  3. An oral adsorbent, AST-120, combined with a low-protein diet and RAS blocker, for chronic kidney disease. Yorioka N, Kiribayashi K, Naito T, Ogata S, Yokoyama Y, Kyuden Y, Ogawa T, Wada K, Hayashi K, Hirabayashi A. In: J Nephrol. 2008 Mar-Apr;21(2):213-20.
  4. Am J Gastroenterol. 2008 Jul;103(7):1721-9. Epub 2008 Jul 4. Oral spherical adsorptive carbon for the treatment of intractable anal fistulas in Crohn's disease: a multicenter, randomized, double-blind, placebo-controlled trial. Fukuda Y, Takazoe M, Sugita A, Kosaka T, Kinjo F, Otani Y, Fujii H, Koganei K, Makiyama K, Nakamura T, Suda T, Yamamoto S, Ashida T, Majima A, Morita N, Murakami K, Oshitani N, Takahama K, Tochihara M, Tsujikawa T, Watanabe M.
  5. What is new in uremic toxicity? Raymond Vanholder, Steven Van Laecke, and Griet Glorieux. In: Pediatr Nephrol. 2008 August; 23(8): 1211–1221.
  6. Oral ADSORBENT AST-120 decreases carotid intima-media thickness and arterial stiffness in patients with chronic renal failure. Nakamura T, Kawagoe Y, Matsuda T, Ueda Y, Shimada N, Ebihara I, Koide H. In: Kidney Blood Press Res. 2004;27(2):121-6. Epub 2004 Mar 26.