Effect of a hydrogen (H₂)‐enriched solution on the albumin redox of hemodialysis patients

Abstract

Elevated oxidative stress (OS) is associated with severe cardiovascular disease and premature death among patients treated with hemodialysis (HD). Oxidative stress is enhanced by contact between blood and dialysis membranes during HD sessions. This study aimed to clarify whether hydrogen (H2), which is a known antioxidant, is capable of suppressing increased OS induced during HD sessions. Eight patients on regular HD treatment were studied. Two HD sessions were performed in a cross-over design trial using standard and hydrogen-enriched solutions (mean of 50 p.p.b. H2; H2-HD). Blood samples were obtained from the inlet and outlet of the dialyzer during HD to determine changes in plasma levels of glutathione, hydrogen peroxide, and albumin redox state as a marker of OS. Comparison of inlet and outlet blood revealed significant decreases in total glutathione and reduced glutathione, as well as significant increases in hydrogen peroxide in both HD treatments. However, the mean proportion of reversibly oxidized albumin in outlet serum was significantly lower than that in inlet serum following the H2-HD session, whereas no significant changes were found in the standard solution session, suggesting that "intra-dialyzer" OS is reduced by H2 -HD. In conclusion, the application of H2-enriched solutions could ameliorate OS during HD.

Improvement of the fraction of human mercaptalbumin on hemodialysis treatment using hydrogen-dissolved hemodialysis fluid: a prospective observational study

“…The data of our study indicated similar results but the significant difference with healthy subjects was not only the f(HMA) of post-HD in EWHD2015, but the low numerical value. As to previous study regarding the relationship between HSA-redox and EW-HD, Terawaki et al [14] reported the beneficial effect of single EW-HD session on HSA-redox [14]. Our present study, however, deals with the long-term (201~392 days) effect of EW-HD treatment on HSA-redox profile.…”

“…Therefore, EW-HD is more likely to contribute to the rise of HMA. Long-term EW-HD treatment presumably resulted in the rise of HMA by the accumulation of albumin reduction effect in the dialyzer [14] and/or the improvement of blood vessel wall function [15]. In a comparison of EWHD2014 and EW2015, the pre-HD f(HMA) values increased and the difference in the f(HMA) value between pre-and post-HD decreased.…”

“…HMA and HNA (human nonmercaptalbumin) were measured by high-performance liquid chromatography (HPLC) as reported in the previous paper [14]. Briefly, the HPLC system consisted of an AS-8010 auto-sampler (Tosoh, Tokyo, Japan; 2 μL injection volume) and a CCPM doubleplunger pump (Tosoh) in conjunction with a CO-8011 system controller (Tosoh).…”

“…One previous report showed that EW-HD might improve OS more effectively than conventional HD (C-HD) session. In this report, the authors adapted the redox state of human serum albumin (HSA-redox) as a marker of OS: they found that a fraction of reduced albumin (human mercaptalbumin (f(HMA))) rose at the dialyzer outlet only on EW-HD treatment [14]. However, there is still no long-term study regarding the long-term effect of EW-HD on HSA-redox profile.…”

The hydrogen molecule as antioxidant therapy: clinical application in hemodialysis and perspectives

“…There is an increase of reduced/oxidized albumin ratio by single HD session using H 2 -enriched solution [100]. In an ex vivo study, there was an increased oxidative injury of polymorphonuclear leukocytes during HD, but the injury was reduced with the use of H 2 -enriched solution [27].…”