AST-120 Protects Cognitive and Emotional Impairment in Chronic Kidney Disease Induced by 5/6 Nephrectomy

Abstract

Background: Uremic toxins resulting from chronic kidney disease (CKD) can cause cognitive and emotional disorders, as well as cardiovascular diseases. Indoxyl sulfate (IS) and p-cresol are notable uremic toxins found in patients with CKD. However, few studies have investigated whether reducing uremic toxins can alleviate cognitive and emotional disorders associated with CKD. Methods: We studied the effects of AST-120, which lowers IS levels, through behavioral tests, local field potentials, field excitatory postsynaptic potentials, and histological experiments in a 5/6 nephrectomy CKD model. Results: We confirmed AST-120’s effectiveness in CKD by measuring serum creatinine, blood urea nitrogen, and IS levels and performing renal tissue staining. Behavioral phenotypes indicated an alleviation of cognitive and anxiety disorders following AST-120 treatment in CKD-induced rats, which was further validated through local field potentials and field excitatory postsynaptic potential recordings. Double immunofluorescence staining for aquaporin-4 and glial fibrillary acidic protein in the hippocampus of CKD rats treated with AST-120 showed reduced coexpression. Conclusions: Our findings demonstrate the potential therapeutic effects of AST-120 in lowering IS levels and improving cognitive and emotional impairments associated with CKD.

Keywords

• chronic kidney disease
• AST-120
• cognitive phenotypes
• blood–brain barrier
• indoxyl sulfate