Hydrogen-Enhanced Dialysis Solution Protects Kidney Patients' Membranes

Authors
Journal
BMC Nephrology
Year
DOI
10.1186/s12882-017-0741-0
Study Type
Rat
Outcome
Positive
Peer Reviewed
Yes
Country
Japan
Health Condition
End-Stage Kidney Disease
Body System
Renal

TL;DR

Adding molecular hydrogen to peritoneal dialysis solutions helps protect the lining of the abdomen in rats from damage caused by the dialysis process.

Key Finding

Peritoneal dialysis solutions enriched with dissolved molecular hydrogen reduced damage to the peritoneal membrane's protective cell layer and decreased markers of cell death and inflammation in rats.

Summary

This rat study tested whether adding molecular hydrogen (H2, a gas) to peritoneal dialysis solutions could protect the peritoneal membrane—the lining inside the abdomen used in kidney dialysis treatment. Researchers gave rats different dialysis solutions over 10 days and found that solutions containing H2 reduced damage to the membrane's protective cell layer and caused less inflammation compared to standard dialysis solutions, even when iron (which causes oxidative damage) was added.

Practical Takeaway

This early-stage rat study suggests that adding hydrogen to dialysis solutions may help protect the peritoneal membrane from damage during long-term treatment. However, this is animal research only, and it remains unclear whether these benefits would translate to humans or how practical it would be to implement clinically. Much more research, including human trials, would be needed before this could become a standard treatment option.

Abstract

Background Peritoneal dialysis (PD) is used as renal replacement therapy in patients with end-stage kidney disease. However, peritoneal membrane failure remains problematic and constitutes a critical cause of PD discontinuation. Recent studies have revealed the unique biological action of molecular hydrogen (H2) as an anti-oxidant, which ameliorates tissue injury. In the present study, we aimed to examine the effects of H2 on the peritoneal membrane of experimental PD rats. Method Eight-week-old male Sprague-Dawley rats were divided into the following groups (n = 8–11 each) receiving different test solutions: control group (no treatment), PD group (commercially available lactate-based neutral 2.5% glucose PD solution), and H2PD group (PD solution with dissolved H2 at 400 ppb). Furthermore, the influence of iron (FeCl3: 5 μM: inducer of oxidative cellular injury) in the respective PD solutions was also examined (Fe-PD and Fe-H2PD groups). The H2PD solution was manufactured by bathing a PD bag in H2-oversaturated water created by electrolysis of the water. Twenty mL of the test solutions were intraperitoneally injected once a day for 10 days. Parietal peritoneum samples and cells collected from the peritoneal surface following treatment with trypsin were subjected to analysis. Results In the PD group as compared to controls, a mild but significant sub-mesothelial thickening was observed, with increase in the number of cells in the peritoneal surface tissue that were positive for apoptosis, proliferation and vimentin, as seen by immunostaining. There were significantly fewer of such changes in the H2PD group, in which there was a dominant presence of M2 (CD163+) macrophages in the peritoneum. The Fe-PD group showed a significant loss of mesothelial cells with sub-mesothelial thickening, these changes being ameliorated in the Fe-H2PD group. Conclusion H2-dissolved PD solutions could preserve mesothelial cells and peritoneal membrane integrity in PD rats. Clinical application of H2 in PD could be a novel strategy for protection of peritoneal tissue during PD treatment.