Hydrogen-Enhanced Dialysis Solution Protects Kidney Patients' Membranes
- Authors
- Masaaki Nakayama, Kimio Watanabe, Yoshimitsu Hayashi, Hiroyuki Terawaki, Wan-Jun Zhu, Shigeru Kabayama, Sadayoshi Ito
- Journal
- Contributions to Nephrology
- Year
- 2018
- DOI
- 10.1159/000485717
- Study Type
- Human
- Outcome
- Positive
- Peer Reviewed
- Yes
- Country
- Japan
- Health Condition
- Chronic Kidney Disease
- Body System
- Renal
TL;DR
Adding molecular hydrogen to peritoneal dialysis solution (PDS) may protect the lining of the abdomen and improve the treatment's safety and effectiveness.
Key Finding
Hydrogen-enriched peritoneal dialysis solution preserved the abdominal membrane lining better than standard solution in animal studies and showed no safety issues in a small 6-patient trial.
Summary
Peritoneal dialysis is a kidney treatment that uses fluid placed in the abdomen to filter waste, but the fluid can damage the membrane lining the abdomen over time. This study tested whether adding molecular hydrogen (a gas) to the dialysis fluid could reduce this damage. In animal experiments, hydrogen-enriched fluid preserved more of the protective cell lining and reduced membrane thickening. A small 2-week trial in 6 patients using hydrogen-enriched fluid showed no safety concerns and some signs of improved cell regeneration.
Practical Takeaway
This early-stage research suggests hydrogen-enriched dialysis solution may help protect the peritoneal membrane in kidney patients, but the human evidence is very limited (only 6 patients over 2 weeks). Much larger and longer clinical trials would be needed before any conclusions about real-world benefit could be drawn.
Abstract
Background: Improved biocompatibility of peritoneal dialysis solution (PDS) is crucial for peritoneal membrane preservation, thereby ensuring long-term peritoneal dialysis (PD) and preventing encapsulating peritoneal sclerosis. We previously reported the protective effect of molecular hydrogen (H2) on mesothelial cells from PDS in nonuremic rats. Summary: In the present study, we examined the effect of H2-containing PDS (commercially available neutral pH type) regarding the protection of peritoneal tissue in experimental chronic kidney disease rats. Furthermore, we conducted a 2-week clinical trial in which H2-containing PDS was used in place of standard PDS and its feasibility was examined. In the experimental study, test solutions were injected through the subcutaneous port into the abdomen for 3 weeks. Histological study revealed a significant increase in the number of mesothelial cells and a significant decrease in peritoneal thickness in the H2-PD group as compared to the control and PD groups. Also, results of immunostaining analysis revealed increased vimentin and apoptotic cells in the membrane of the PD group, indicating that H2 may play a role in ameliorating PDS-induced peritoneal injury and preserving peritoneal integrity. In the clinical trial with 6 prevalent PD patients, all subjects completed the study with no adverse effects. Moreover, there were substantial changes in surrogate markers, such as increased CA125 and mesothelin, in the effluent in selected cases, suggesting enhanced mesothelial regeneration by H2. Key Message: H2-enriched PDS is a candidate novel PDS with improved biocompatibility. Further, our results support the significance of H2-PD clinical trials in the future.