Clinical trial Recruiting at 1 site Interventional Ages 20 and up

Oral uremic toxin absorbent and probiotics to lower inflammation and slow diabetic kidney disease

Official title: Study of Oral Uremic Toxin Absorbent/Probiotics to Modulate Systemic Inflammation and Retard the Progression of Chronic Kidney Disease in Patients With Diabetes.

Run by National Taiwan University Hospital · NCT07333313 · Data updated 2026-11-12

This trial tests whether an oral toxin absorbent alone or combined with probiotics can reduce systemic inflammation and slow kidney decline in adults with diabetes-related chronic kidney disease.

Quick facts

Study typeInterventional
Ages20 Years and up
SexAll
Enrollment300 (estimated)
SponsorNational Taiwan University Hospital
Academic / other
Locations1 site (Taipei, Taiwan)
StatusRecruiting
StartedDecember 31, 2024
Main results expectedMarch 31, 2029
Study endsDecember 31, 2029
Registry record updatedJanuary 15, 2026
Trial IDNCT07333313 on ClinicalTrials.gov

Is this trial a fit for you?

Likely a good fit

Adults over 20 with diabetes and diabetic kidney disease who have stable renal function and PCS levels, fitting one of the trial eGFR strata (approximately 45–60, 30–45, 15–30, or <15 ml/min/1.73 m2) and who are not pregnant are the intended participants.

Probably not a fit

Patients with severe malnutrition (albumin <2.0 g/dL), severe anemia (hemoglobin <8 g/dL), active peptic ulcer/esophageal varices/ileus or active GI bleeding, recent major GI surgery, chronic constipation (<3 bowel movements/week), or baseline eGFR >90 ml/min/1.73 m2 are excluded and unlikely to benefit from this intervention.

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

Adults with diabetic kidney disease and stable renal function will be enrolled at National Taiwan University Hospital and assigned to receive an oral uremic toxin absorbent, probiotics, or the combination. The absorbent (activated charcoal–type) is intended to bind gut-derived uremic toxins while probiotics aim to favorably alter gut microbiota and toxin production. Participants are stratified by baseline eGFR into four groups spanning mild to severe CKD and will have inflammatory markers, p-cresyl sulfate (PCS) levels, creatinine/eGFR, and clinical outcomes monitored over time. Safety exclusions include active gastrointestinal disease, recent GI surgery, severe malnutrition or anemia, and chronic constipation.

Why it matters

Potential benefit: If successful, the intervention could reduce circulating uremic toxins and inflammation, potentially slowing progression of diabetic kidney disease and lowering cardiovascular risk.

How similar studies have gone: Preclinical studies and some small clinical observations have suggested activated charcoal and certain probiotics can lower gut-derived uremic toxins and inflammation, but large randomized data demonstrating clinical benefit are limited.

Who can join: the full rules

Show full inclusion / exclusion criteria
Inclusion Criteria:

1. Age \> 20 years old but not pregnant on the day of screening.
2. DKD patients with stable renal function (Cre elevation \< 0.3 mg/dL for at least 30 days) and PCS level (fluctuation \< 10% for at least 30 days)
3. Group 1: 120 DKD patients with 45\<eGFR\<60 ml/min/1.73m2 in stable status. Group 2: 120 DKD patients with 30\<eGFR\<45 ml/min/1.73m2 in stable status. Group 3: 60 DKD patients with 15\<eGFR\<30 ml/min/1.73m2 in stable status Group 4: 60 DKD patients with eGFR\<15 ml/min/1.73m2 in stable status

Exclusion Criteria:

1. Baseline eGFR \> 90 ml/min/1.73m2 according to MDRD equation.
2. Patients in severe malnutrition status, albumin less than 2.0 g/dL.
3. Patients in severe anemia or active gastrointestinal bleeding with hemoglobulin \< 8 g/dL.
4. Active peptic ulcer, esophageal varices, ileus or under fasting status
5. Previous gastrointestinal operation.
6. Chronic constipation, as defined with less than 3 bowel movements per week, straining, hard stools.
7. Incomplete evacuation and inability to pass stool. If usage of oral laxatives can achieve bowel movement, this patient will not be excluded.
8. Patients with major hemorrhage, as defined with acute hemorrhage and requirement of blood transfusion during index admission.
9. Patients with a biopsy proved or clinically diagnosed advanced liver cirrhosis, Child classification B or C.
10. Solid organ or hematological transplantation recipients.
11. Evidence of obstructive kidney injury or polycystic kidney disease.
12. Presence or history of malignant neoplasms within the past 5 years prior to the day of screening.
13. Patients with Immune Deficiency Syndrome.
14. Antibiotics or probiotics treatment within the last 3 months before enrollment and during follow-up period.

Where it's running

  • National Taiwan University Hospital.
    Taipei, Taiwan, Taiwan
    Recruiting

Study contacts

How to take part

  1. Review the eligibility criteria above with your treating physician.
  2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
  3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.
Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.