Development of innovative peritoneal dialysis treatment using molecular hydrogen

Research underway in the Division of Chronic Kidney Disease (CKD) and Dialysis Treatment at Tohoku University Hospital in Japan, led by Dr Masaaki Nakayama, aims to develop an innovative method in order to efficiently tackle this issue by incorporating molecular hydrogen (H2) into the treatment process. More specifically, the goal of this research is to develop a hydrogen-containing dialysis fluid and haemodialysis system that can quantitatively adjust the amount of hydrogen supplied to patients while elucidating benefits such as suppression of fatigue and itching, as well as blood pressure improvement. 'Research on PD-related peritoneal damage primarily has been focuses on the improvement of dialysis biocompatibility, e.g. glucose degradation products in the dialysate which are generated during the process of manufacturing of dialysate,' explains Nakayama. However, because PD utilises human biomembrane, it is essential to develop innovative methods to ameliorate the toxicity of carbonyl substance transferred from the human body into the dialysis solution. It is for this reason that Nakayama's research is focusing on the antioxidant action of molecular hydrogen. He explains, 'I firstly discovered that advanced glycated endproducts (AGEs) are involved in the development of PD-related peritoneal damage. Subsequent studies revealed that high glucose as well as carbonyl substances, such as methylglyoxal, generate AGEs in the peritoneal membrane and we confirmed that the inhibitor of oxidative stress leads to suppression of AGEs formation.' It was these key discoveries that suggested to the researchers that antioxidant therapy could be a solution to peritoneal damage. Nakayama and his team chose H2 for their investigation into peritoneal dialysis for a number of reasons. Firstly, current antioxidants studied by other groups have exhibited major safety and toxicity issues that prevent their long-term use. It is these safety concerns that are the reason why these antioxidants are still at early stages of animal experiments and have not yet proceeded to clinical trials. However, molecular hydrogen research in clinical and medical applications has emerged in recent times, following the confirmation of its antioxidant and cytoprotective properties. 'This H2-containing dialysate suppress oxidative stress in the human body and thus protects the peritoneum. Furthermore, the administration of molecular hydrogen within the human body may contribute to preservation of residual kidney function and suppression of development of cardiovascular events. This underlines the possibility that H2 peritoneal dialysis therapy has the capacity to improve the patient's overall prognosis and eventually could be a novel therapy for the treatment of renal failure,' states Nakayama.