The hydrogen molecule as antioxidant therapy: clinical application in hemodialysis and perspectives

Increased oxidative stress and pro-inflammatory conditions, commonly present in chronic dialysis patients, are thought to be enhanced during hemodialysis (HD) and to be associated with the excess morbidity and mortality seen in these patients. The hydrogen molecule (H2) has a unique biological capacity to act as an antioxidative and anti-inflammatory substance. In light of accumulating evidence from animal studies showing protective effects against organ damage during ischemia and inflammation, development of H2 treatments for HD patients has become a challenging clinical goal. An HD system utilizing a water electrolysis technique that renders large amounts of H2-enriched water has been developed. During HD with an H2-enriched solution (approximately 50 ppb H2), markers of increased oxidative stress (such as interleukin-6, myeloperoxidase, methemoglobin, increased lymphocyte apoptosis, and high blood pressure) are suppressed. These findings indicate that the use of an H2-enriched solution may prove to be a novel approach to ameliorate dialysis-related complications. This manuscript reviews the recent progress in H2 research and the use of H2 in HD patients, including a description of a water electrolysis technique that delivers large amounts of H2-enriched water for use in clinical settings.