Clinical Use and Treatment Mechanism of Molecular Hydrogen in the Treatment of Various Kidney Diseases including Diabetic Kidney Disease

Abstract

As diabetes rates surge globally, there is a corresponding rise in the number of patients suffering from diabetic kidney disease (DKD), a common complication of diabetes. DKD is a significant contributor to chronic kidney disease, often leading to end-stage renal failure. However, the effectiveness of current medical treatments for DKD leaves much to be desired. Molecular hydrogen (H2) is an antioxidant that selectively reduces hydroxyl radicals, a reactive oxygen species with a very potent oxidative capacity. Recent studies have demonstrated that H2 not only possesses antioxidant properties but also exhibits anti-inflammatory effects, regulates cell lethality, and modulates signal transduction. Consequently, it is now being utilized in clinical applications. Many factors contribute to the onset and progression of DKD, with mitochondrial dysfunction, oxidative stress, and inflammation being strongly implicated. Recent preclinical and clinical trials reported that substances with antioxidant properties may slow the progression of DKD. Hence, we undertook a comprehensive review of the literature focusing on animal models and human clinical trials where H2 demonstrated effectiveness against a variety of renal diseases. The collective evidence from this literature review, along with our previous findings, suggests that H2 may have therapeutic benefits for patients with DKD by enhancing mitochondrial function. To substantiate these findings, future large-scale clinical studies are needed.

Study details

Article type

Review

Disease / injury model

Diabetic Kidney Disease (DKD), Chronic Kidney Disease (CKD), Acute Kidney Injury (AKI), Renal Fibrosis, Drug-induced Nephrotoxicity, Sepsis-related AKI, Renal Transplantation, Renal Stones

Dose comparison

The review discusses different concentrations and dosages of hydrogen in various forms (gas, water, saline, dialysate) across studies, but notes that optimal concentrations and dosages for specific diseases remain unclear.

Outcome

Positive

Findings

The review concludes that molecular hydrogen (H2) demonstrates therapeutic potential in various animal models of renal disease and in human dialysis patients, particularly for diabetic kidney disease (DKD), by improving mitochondrial function, reducing oxidative stress and inflammation, and regulating cell lethality and intracellular signaling. However, large-scale clinical trials are needed to confirm these effects in DKD.