Effect of Spherical Adsorptive Carbon Among Chronic Kidney Disease Patients: A Nationwide Cohort Study

Dong Hui Shin, Keunryul Park, Jae Won Yang and Jun Young Lee ()
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Dong Hui Shin: Department of Nephrology, Comprehensive Kidney Disease Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea
Keunryul Park: Department of Nephrology, Comprehensive Kidney Disease Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea
Jae Won Yang: Department of Nephrology, Comprehensive Kidney Disease Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea
Jun Young Lee: Department of Nephrology, Comprehensive Kidney Disease Research Institute, Wonju College of Medicine, Yonsei University, Wonju 26426, Republic of Korea

IJERPH, 2025, vol. 22, issue 9, 1-10

Abstract: Spherical Adsorptive Carbon (SAC), a type of oral sorbent, is prescribed to chronic kidney disease (CKD) patients to remove uremic toxins. However, evidence regarding its effectiveness in delaying chronic kidney disease (CKD) progression remains insufficient. We aimed to evaluate the impact of SAC on CKD progression in patients with CKD stage 3 or higher using nationwide data. In this retrospective cohort study, we included patients diagnosed with CKD stage ≥3 from the Korea National Health Insurance System database between January 2020 and December 2022. Outcomes were compared between SAC users (N = 1289) and non-users (N = 1289) after 1:1 propensity score matching (PSM). After PSM, the time from index date to end-stage kidney disease (ESKD) was significantly longer in the SAC user group compared to the non-user group (246.8 days vs. 118.6 days, p < 0.001). In Cox regression analysis, the risk of ESKD was significantly lower in the SAC group (HR = 0.37, 95% CI: 0.29–0.48). However, the risk of dialysis initiation did not show a significant difference between the two groups (HR = 0.83, 95% CI: 0.27–2.59). This nationwide cohort study suggests that SAC treatment may delay progression from CKD stage 3 to ESKD, although it did not significantly reduce the risk of dialysis initiation.

Keywords: cohort studies; disease progression; kidney diseases; chronic; renal replacement therapy; survival analysis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2025
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