{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T05:58:42Z","timestamp":1790747922696,"version":"4.1.0"},"reference-count":55,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH-1140604C"],"award-info":[{"award-number":["TCVGH-1140604C"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH-1133603C"],"award-info":[{"award-number":["TCVGH-1133603C"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010101","name":"Taichung Veterans General Hospital","doi-asserted-by":"publisher","award":["TCVGH-1123603C"],"award-info":[{"award-number":["TCVGH-1123603C"]}],"id":[{"id":"10.13039\/501100010101","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Science Progress"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      Chronic kidney disease (CKD) progression has been associated with the accumulation of protein-bound uremic toxins (PBUTs), such as indoxyl sulfate and p-cresyl sulfate. AST-120, an oral carbon adsorbent, and probiotics (e.g.,\n                      <jats:italic toggle=\"yes\">Lactobacillus<\/jats:italic>\n                      ) have been used in clinical practice to modulate PBUT burden, but comparative real-world data on long-term outcomes remain limited.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective, multinational study using de-identified electronic health records from TriNetX Global Collaborative Network. Adult patients (\u226518 years) with baseline estimated glomerular filtration rate &lt;60 mL\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      who received AST-120 or\n                      <jats:italic toggle=\"yes\">Lactobacillus<\/jats:italic>\n                      between January 2001 and July 2025 were identified. After 1:1 propensity score matching on 16 baseline covariates, 340 patients were included in each group. Primary outcomes were progression to stage 4 or 5 CKD, end-stage kidney disease (ESKD), and all-cause mortality. Time-to-event analyses were performed using Cox proportional hazards models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over mean follow-up of 2.3 years, AST-120 use was associated with lower risks of progression to stage 4 CKD (HR 0.294; 95% CI 0.148\u20130.586), stage 5 CKD (HR 0.488; 95% CI 0.296\u20130.805), ESKD (HR 0.333; 95% CI 0.168\u20130.663), and all-cause mortality (HR 0.508; 95% CI 0.351\u20130.735), compared with a probiotic-exposed reference cohort. The composite outcome of ESKD or mortality showed a similar association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this propensity score\u2013matched real-world cohort, AST-120 use was associated with more favorable renal and survival outcomes compared with a probiotic-exposed reference population. Given the observational design and potential for residual confounding, these findings should be interpreted as hypothesis-generating.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00368504261468477","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T12:14:34Z","timestamp":1783944874000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of AST-120 and probiotics (\n                    <i>lactobacillus<\/i>\n                    ) on renal function in patients with chronic kidney disease: A retrospective cohort study from the TriNetX global collaborative network"],"prefix":"10.1177","volume":"109","author":[{"given":"Chang","family":"Chi-Hsien","sequence":"first","affiliation":[{"name":"Show Chwan Memorial Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6119-0587","authenticated-orcid":false,"given":"Shang-Feng","family":"Tsai","sequence":"additional","affiliation":[{"name":"Tunghai University"},{"name":"National Chung Hsing University"},{"name":"Taichung Veterans General Hospital"},{"name":"Taichung Veterans General Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2210639"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011161"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa011303"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2024816"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2204233"},{"issue":"4","key":"e_1_3_7_7_2","doi-asserted-by":"crossref","first-page":"S117","DOI":"10.1016\/j.kint.2023.10.018","article-title":"Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease","volume":"105","author":"KDIGO 2024","year":"2024","unstructured":"KDIGO 2024. Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. 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