Possible clinical effects of molecular hydrogen (H2) delivery during hemodialysis in chronic dialysis patients: Interim analysis in a 12 month observation

Abstract

Background and aimIt is supposed that enhanced oxidative stress and inflammation are involved with the poor clinical outcomes in patients on chronic dialysis treatment. Recent studies have shown that molecular hydrogen (H2) is biologically active as an anti-inflammatory agent. Thus, we developed a novel hemodialysis (E-HD) system which delivers H2 (30 to 80 ppb)-enriched dialysis solution, to conduct a prospective observational study (UMIN000004857) in order to compare the long-term outcomes between E-HD and conventional-HD (C-HD) in Japan. The present interim analysis aimed to look at potential clinical effects of E-HD during the first 12 months observation.Subjects and method262 patients (140, E-HD; 122, C-HD) were subjected for analysis for comprehensive clinical profiles. They were all participating in the above mentioned study, and they had been under the respective HD treatment for 12 consecutive months without hospitalization. Collected data, such as, physical and laboratory examinations, medications, and self-assessment questionnaires on subjective symptoms (i.e., fatigue and pruritus) were compared between the two groups.ResultsIn a 12-month period, no clinical relevant differences were found in dialysis-related parameters between the two groups. However, there were differences in the defined daily dose of anti-hypertensive agents, and subjective symptoms, such as severe fatigue, and pruritus, which were all less in the E-HD group. Multivariate analysis revealed E-HD was an independent significant factor for the reduced use of anti-hypertensive agents as well as the absence of severe fatigue and pruritus at 12 months after adjusting for confounding factors.ConclusionThe data indicates E-HD could have substantial clinical benefits beyond conventional HD therapy, and support the rationale to conduct clinical trials of H2 application to HD treatment.

Molecular hydrogen regulates PTEN‐AKT‐mTOR signaling via ROS to alleviate peritoneal dialysis‐related peritoneal fibrosis

“…For example, oxidized albumin can be reduced after the use of hydrogen‐containing blood dialysate, which can also relieve oxidative stress during hemodialysis and reduce the incidence of cardiovascular events. Therefore, hydrogen‐rich dialysate can reduce the occurrence of end‐point events and improve the prognosis of patients compared with conventional hemodialysis …”

“…Therefore, hydrogen-rich dialysate can reduce the occurrence of end-point events and improve the prognosis of patients compared with conventional hemodialysis. 39,40 The hydrogen-containing peritoneal dialysate was first applied in rat model, and peritoneal fibrosis is effectively prevented after the administration of peritoneal dialysis. 20 There was a case report in which hydrogen-containing peritoneal dialysate and hemodialysis solution were applied for 63 days in an encapsulated peritoneal sclerosis (EPS) patient, and the peritoneal biopsy result showed that the intestinal cysts were not obvious.…”

Comparisons of fatigue between dialysis modalities: A cross-sectional study

“…Grades 3, 4 and 5 are regarded as fatigued states. We have already used this scale for the assessment of fatigue in two previous studies [14,15]. Although the effectiveness of this scale has not yet been validated, we used this scale because of its usability and lower cost than other scales.…”

Hydrogen molecules (H2) improve perfusion recovery via antioxidant effects in experimental peripheral arterial disease

“…Currently, there is no known pharmaceutical therapy that is able to improve blood perfusion in the ischemic limbs of patients with PAD ( 2 , 6 ). Hydrogen gas inhalation or hydrogen-saturated water has been widely used in a variety of clinical conditions, including strokes, and its efficacy and safety in patients has been demonstrated in previous studies ( 31 , 32 ). In line with these studies, the present study demonstrated that oral administration of H 2 was effective for the treatment of PAD, which is a convenient method for clinical use.…”