Novel haemodialysis (HD) treatment employing molecular hydrogen (H2)-enriched dialysis solution improves prognosis of chronic dialysis patients: A prospective observational study

Abstract

Recent studies have revealed unique biological characteristics of molecular hydrogen (H2) as an anti-inflammatory agent. We developed a novel haemodialysis (E-HD) system delivering an H2 (30–80 ppb)-enriched dialysis solution by water electrolysis, and conducted a non-randomized, non-blinded, prospective observational study exploring its clinical impact. Prevalent chronic HD patients were allocated to either the E-HD (n = 161) group or the conventional HD (C-HD: n = 148) group, and received the respective HD treatments during the study. The primary endpoint was a composite of all-cause mortality and development of non-lethal cardio-cerebrovascular events (cardiac disease, apoplexy, and leg amputation due to peripheral artery disease). During the 3.28-year mean observation period, there were no differences in dialysis parameters between the two groups; however, post-dialysis hypertension was ameliorated with significant reductions in antihypertensive agents in the E-HD patients. There were 91 events (50 in the C-HD group and 41 in the E-HD group). Multivariate analysis of the Cox proportional hazards model revealed E-HD as an independent significant factor for the primary endpoint (hazard ratio 0.59; [95% confidence interval: 0.38–0.92]) after adjusting for confounding factors (age, cardiovascular disease history, serum albumin, and C-reactive protein). HD applying an H2-dissolved HD solution could improve the prognosis of chronic HD patients.

Study details

Article type

Original Research

Disease / injury model

Chronic kidney disease (end-stage renal disease) in haemodialysis patients

Duration

3 years

Dose comparison

No direct dose/concentration comparison within the E-HD group; all patients received 30–80 ppb H2.

Outcome

Positive

Findings

During the 3.28-year mean observation period, there were no differences in dialysis parameters between the two groups. However, post-dialysis hypertension was ameliorated with significant reductions in antihypertensive agents in the E-HD patients. Additionally, haemodialysis using H2-enriched dialysis solution (E-HD) significantly reduced the risk of all-cause mortality and non-lethal cardio-cerebrovascular events compared to conventional HD, with improved post-dialysis hypertension and reduced need for antihypertensive agents, and no observed adverse effects.