Effect of a hydrogen (H2)-enriched solution on the albumin redox of hemodialysis patients.

Abstract

Hemodialysis (HD) patients experience heightened oxidative stress, partly driven by blood-membrane contact during dialysis sessions, which contributes to elevated cardiovascular risk. In this crossover trial involving 8 regular HD patients, two sessions were conducted using either a standard dialysate or a hydrogen-enriched dialysate (mean H2 concentration: 50 ppb). Blood collected at the dialyzer inlet and outlet was analyzed for total and reduced glutathione, hydrogen peroxide, and albumin redox state. Both dialysate conditions produced significant reductions in glutathione and increases in hydrogen peroxide. Notably, only the hydrogen-enriched session showed a significant decrease in the proportion of reversibly oxidized albumin between inlet and outlet samples, indicating that intra-dialyzer oxidative stress was attenuated by H2. These findings suggest that incorporating H2 into dialysate solutions may reduce oxidative burden during HD.

Mechanism

H2 dissolved in the dialysate is thought to directly scavenge reactive oxygen species generated at the blood-membrane interface within the dialyzer, thereby reducing reversible albumin oxidation and overall oxidative stress during the HD session.