Abstract: TH-OR003

Clinical Effects of Molecular Hydrogen (H2) Delivery during Hemodialysis in Chronic Dialysis Patients: Five Years Prospective Observational Study

Session Information

Category: Dialysis

  • 606 Dialysis: Epidemiology, Outcomes, Clinical Trials - Cardiovascular

Authors

  • Nakayama, Masaaki, Tohoku University, Tohoku University Hospital, Sendai City, Japan
  • Zhu, Wan-Jun, Tohoku University, Tohoku University Hospital, Sendai City, Japan
  • Yamamoto, Tae, Tohoku University, Sendai, MIYAGI, Japan
  • Miyazaki, Mariko, Tohoku University Hospital, Sendai, Japan
  • Ito, Sadayoshi, Tohoku Graduate School of Medicine, Sendai Miyagi, Japan
Background

Enhanced oxidative stress and inflammation are supposed to play a crucial role for poor clinical outcomes in patients on chronic hemodialysis (HD) treatment. Recent studies have revealed unique biological characteristics of molecular hydrogen (H2) as an anti-inflammatory agent. Thus, we developed a novel hemodialysis (E-HD) system which delivers H2 (30 to 80 ppb)-enriched dialysis solution by water electrolysis technique, and conducted a prospective study (UMIN000004857) to study the clinical impact of E-HD as compared to the conventional-HD (C-HD).

Methods

Prevalent chronic HD patients (n=309, mean HD vintage, 7.8 years; age, 66 years old; male, 57%; history of cardio- and cerebro-vascular disease (CVD), 29%)were registered from 7 HD centers in Japan (from Mar 2011 to Dec 2012), and allocated to either E-HD (n= 161), orC-HD (n=148). They had been treated by the respective HD treatments during the study. Primary end-point was composite of all-cause of mortality, and development of non-lethal CVDs (apoplexy, cardiac diseases, and peripheral artery disease).

Results

During the five-year observation periods (end of Oct 2016), no differences were found in dialysis parameters between the two groups. However, there were uniquechanges in clinical profiles in patients on E-HD, i.e. significant reduction in post-HD systolic BP in those who had remained hypertensive state after HD at baseline, which was accompanied by significant reductions ofprescriptions of anti-hypertensive agents. There were 91 events during the mean observation periods of 3.28 years. The number of primary events were 50 cases in C-HD (17 in death and 29 in CVD: Event Rate; 107.1 /1000 patients-year:95%CI:81.2-141.1), and 41 cases in E-HD (20 in death and 20 in CVD:Event Rate;75.4:55.6-102.2), respectively.Multivariate analysis of Cox proportional hazard model revealed that E-HD was an independent significant factor for the primary event (HR 0.59, 95%CI:0.38-0.92) after adjusting for confounding factors (age, history of CVD, serum albumin, and CRP).

Conclusion

The data indicates E-HD could improve prognosis of chronic HD patients, through the unique BP control effect during HD treatment.

Funding

  • Commercial Support