Chronic kidney disease (CKD) is an increasingly prevalent and disproportionately costly condition. The majority of patients are treated by haemodialysis (HD) which primarily removes small water soluble molecules. However, most protein bound and larger molecular weight azotaemic toxins remain within the body and accumulate, impairing cardiovascular function and contributing to the morbidity and mortality of HD. Adsorbent therapies with the capacity to remove key protein bound and larger azotaemic toxins not removed by HD may solve this and also delay the need to start HD. Recent advances in synthetic carbon technology using multi-modal, highly adsorbent carbons may provide an effective sorbent adjunct to augment HD.
As an important source of these toxins is the intestine, where azotaemic compounds are introduced into the body either via the diet or via in situ generation, our hypothesis is that orally administered mesoporous carbon adsorbents may be of clinical benefit in CKD via their ability to remove azotaemic toxins within the gut. Our preliminary data has shown that adsorbents are efficacious and capable of removing albumin-bound molecules and azotaemic toxins from physiological solutions in vitro.