Novel haemodialysis treatment employing molecular hydrogen-enriched dialysis solution improves prognosis of chronic dialysis patients: a prospective observational study
Nakayama M et al. · Sci Rep. 2018;8:254.
What kind of evidence is this?
Human
Non-randomized, non-blinded prospective multicenter observational comparison
Kidney and urinary health
Other forms
Not reported in this record.
Not reported in this record.
Methods at a glance
Adults receiving chronic maintenance hemodialysis
309 patients: H₂-enriched dialysis n=161; conventional dialysis n=148
Mean observation 3.28 years; dialysis three times weekly
Hemodialysis with 30–80 ppb H₂-enriched dialysate, three sessions per week for 4–5 hours
H₂ dissolved in dialysis solution — H₂ only, not Brown’s gas and not inhalation.
30–80 ppb dissolved H₂; approximately 1.2 mmol H₂ estimated to enter the patient during a 4-hour session at 50 ppb.
Not applicable — H₂ was dissolved in dialysate. Dialysate flow was 500 mL/min, but this is not an H₂ gas-flow value.
No O₂ was co-delivered as part of the H₂ intervention.
Conventional hemodialysis with dialysate H₂ below 1 ppb
Outcomes and reported result
Composite of all-cause mortality and non-fatal cardio-cerebrovascular events; blood pressure, medications, dialysis parameters, fatigue and pruritus
There were 91 composite events: 41 with H₂-enriched dialysis and 50 with conventional dialysis. The adjusted hazard ratio was 0.59 (95% CI 0.38–0.92), while the unadjusted association was not statistically significant.
Methods, results, registration, funding and conflicts checked in the open-access full text; independent appraisal remains incomplete.
A reported association, difference or mechanism is not automatically a clinical benefit. Null findings, outcome type, study design and precision all matter.
Cautions and applicability
Treatment was selected by physicians rather than randomized, the H₂ group was younger, and residual confounding is likely. The favorable estimate appeared after multivariable adjustment. Nihon Trim, manufacturer of the electrolysis system, funded the study; authors declared no competing interests.
Chronic hemodialysis patients in Japanese centers using this specific H₂-enriched dialysate system.
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No single-study GRADE certainty rating is assigned. Certainty is assessed by important outcome across a complete eligible evidence set, not by attaching a final grade to one source.
Sources and record status
PMID: 29321509 · DOI: 10.1038/s41598-017-18537-x
Open-access full text is available through PMC and the publisher.
Open-access PMC and publisher full texts plus PubMed record.
2026-08-10