Hydrogen-enriched hemodialysis (E-HD) significantly reduced dialysis-related fatigue in patients with activity reduction through modulation of energy metabolism pathways, including fatty acid metabolism, citric acid cycle, and glycolysis. The treatment demonstrated improvements in body composition with increased skeletal muscle mass and reduced body fat, suggesting E-HD may represent an innovative therapeutic approach beyond conventional solute removal-based dialysis for managing uremia-related complications.
Plain-Language Summary
This study followed 81 hemodialysis patients for 12 months to see if using hydrogen-enriched dialysis solution (created through water electrolysis) could reduce fatigue. Patients were grouped by fatigue severity. Those with fatigue that limited their activities showed significant improvement after 12 months of hydrogen-enriched dialysis, while those without fatigue or with fatigue that didn't limit activities saw no change. The researchers found that hydrogen-enriched dialysis appeared to affect how patients' bodies produce and use energy, particularly in pathways involving fat burning and glucose metabolism.
Abstract
Hemodialysis employing molecular hydrogen (H2)-enriched dialysis solution rendered by water electrolysis (E-HD), has been reported to alleviate dialysis-related fatigue, but its association with metabolic profiles remains unclear. Eighty-one patients undergoing standard HD were classified into 3 groups [Group A (n = 25, 30.9%): fatigue with activity reduction-subgroups A1: chronic persistent fatigue (n = 11), A2: fatigue only on dialysis days (n = 14); Group B: fatigue without activity reduction (n = 24, 29.6%); Group C (n = 32, 39.5%): no fatigue], and their changes in fatigue, body composition, and metabolic profiles were studied following 12 months of E-HD. There were no significant differences in baseline characteristics among the groups. Over the 12 months after E-HD initiation, fatigue in Group A significantly decreased, while no changes in Group-B and C. Bio-impedance analysis revealed no significant changes in A1, but significant reductions in body fat and increases in skeletal muscle mass were observed despite no significant weight change in A2. Enrichment analysis suggested significant differences in metabolic pathways such as fatty acid metabolism, citric acid cycle, and glycolysis between Groups A and C at baseline, and these differences were mitigated by E-HD. E-HD could suppress dialysis-related fatigue, through possible involvement of altered energy metabolism of patients. E-HD may represent a new paradigm for uremia treatment beyond traditional solute removal-based dialysis therapies.
