NPPA and chronic kidney disease: [31] Another study of pre-dialysis CKD patients showed significantly reduced arterial stiffness and carotid intima media thickness. [32] Cardiorenal protective effects of long-term (2 years) AST-120 treatment have been demonstrated in chronic heart failure patients with moderate CKD. These patients had an improvement in renal function, edema, ANP levels, cardiothoracic ratio, length of hospital stay and a reduced number of admissions after AST-120 treatment, compared to before treatment. [33] However, mechanisms of the cardioprotective effects of AST-120 have not been not well-explored.