Abstract
BACKGROUND: The role of uremic toxins in the progression of chronic kidney disease (CKD) and novel treatments to mitigate their effects are critical areas of research. This pilot study investigated the efficacy of a novel activated bamboo charcoal and/or probiotics in reducing uremic toxins and improving renal function in CKD patients. METHODS: This prospective, randomized, open, blinded end-point (PROBE) study included patients with stage 3 CKD. Patients were randomly assigned to one of four groups: activated bamboo charcoal (ABC), probiotics, ABC with probiotics, or standard treatment for 3 months. RESULTS: A total of 46 patients were enrolled (mean age 66.7 ± 11.5 years, 71.7% male). The ABC and ABC with probiotics groups showed a significant reduction in serum levels of the uremic toxins trimethylamine N-oxide (TMAO), p-cresyl sulfate (PCS), indoxyl sulfate (IS), and phenyl sulfate (PS) after 3 months of treatment (all p < 0.05). There was a particularly pronounced decrease in the percentage of IS in both the ABC group (-23.9 ± 28.9% vs. 33.9 ± 63.4%, p = 0.005) and the ABC with probiotics group (-29.3 ± 30.6% vs. 33.9 ± 63.4%, p = 0.009). The eGFR change ratio also significantly improved in the ABC group compared to the control group (4.6 ± 10.2% vs. -8.6 ± 12.5%, p = 0.011). However, the probiotics group did not exhibit a similar reduction in uremic toxins or an improvement in the eGFR. CONCLUSION: This study suggested that ABC significantly reduced uremic toxins and might have potential in improving eGFR in CKD stage 3 patients over a 3-month period. These findings suggest a potential protective effect of ABC on kidney function, highlighting the need for further large-scale, long-term randomized controlled trials to confirm these results.