A combination of two oral sorbents,
oxystarch 35 g/day plus
activated charcoal 35 g/day, was administered to four patients undergoing maintenance
hemodialysis during thrice weekly and once weekly treatments. Patients tolerated
oxystarch and
charcoal without complaint during the 4-week period of thrice weekly
hemodialyses. All four patients became clinically uremic when
hemodialyses were reduced to once weekly and only two patients were able to continue through the end of this 4-week period. Mean serum
cholesterol concentration diminished significantly from 200 mg/dl during control periods to 140 mg/dl after each 4-week trial of sorbents (P less than 0.02).
Hypertriglyceridemia (range 181 to 543 mg/dl) was corrected in three of four patients with
triglyceride values falling to less than 150 mg/dl during ingestion of sorbents (P less than 0.05).
Activated charcoal, which is inert as an intestinal
nitrogen binding sorbent, may lower serum
lipids by direct intragut binding of
lipids and
bile acids. The potential use of oral
charcoal in long-term
therapy to reduce
hyperlipidemia and prevent vascular accidents due to
atherosclerosis requires additional study.