2025 Medical gas research Pilot / Observational Human H₂ therapy InhalationSaline / IV Kidney / Dialysis
2025 · Nakazawa et al. — Fatigue Disappearance in Hemodialysis Patients by Dual Approach with Hydrogen Gas Inhalation and Hydrogen-Enriched Dialysate: Two Case Reports
Super-Abstract
In two men on long-term hemodialysis, adding inhaled 2.5% hydrogen during dialysis sessions for 3 months to dialysis with hydrogen-containing dialysate was followed by a fall in the median fatigue score from 3 to 0 on a scale from 0 to 9. Self-rated health on a 0 to 100 scale rose from 30 and 35 to 100. After both patients went back to conventional dialysis, fatigue returned to 9 and self-rated health to 0. These are two uncontrolled case reports without statistical testing. (Medical Gas Research, 2025.)
Commentary
Fatigue is common in people on hemodialysis, and the authors asked whether more hydrogen would relieve it further than hydrogen-containing dialysate alone. The paper has no abstract, so this page draws on the full text. Two men aged 64 and 53, on dialysis for 23 and 30 years at one clinic, had used online hemodiafiltration with electrolysed, hydrogen-containing dialysate (average 300 ppb H₂) for 45 and 76 months. Both then added hydrogen inhalation for 3 months: 2.5% hydrogen gas through a nasal cannula for 4 to 5 hours, three times a week, only during dialysis. The report describes no control group and no blinding. Outcomes were the SONG-HD fatigue score (0 to 9), the EQ-VAS health rating (0 to 100), serum citrullinated histone H3 (CitH3, a marker of neutrophil extracellular traps), other oxidative stress markers, flow-mediated dilation and blood hydrogen levels. Ethical approval was waived because the authors did not classify the report as a research study.
Key quotes
- „The median SONG-HD fatigue scores for conventional HDF, EW-OL-HDF, and combined therapy were 9, 3, and 0 in both patients, respectively.“ — the main result: fatigue scores under the three dialysis regimens
- „As a limitation, we report a case study involving a small number of patients.“ — the only limitation the authors name
- „In conclusion, the results of this case study suggest that our combined therapy can alleviate fatigue in patients undergoing HD.“ — the authors' conclusion, drawn from two patients
Our assessment
Two case reports can describe what happened in two patients. They cannot show that hydrogen caused the change. Limitations: two patients, no control group and no statistical testing. Fatigue and health were self-rated, and nothing in the report indicates that patients were blinded to their treatment. The scores sit at the ends of both scales (fatigue 9 and 0, health 0 and 100). The regimens followed one another over months and years rather than in random order. Post-dialysis CitH3 fell from 8.48 to 1.58 ng/mL in case 1 and from 6.71 to 4.32 ng/mL in case 2, while advanced glycation end-products in case 2 barely changed. Adverse events are not reported. The acknowledgements thank two employees of the company that makes the hydrogen gas generator used in the study.
Study design
- Type: two case reports from one clinic, before-and-after comparison without statistics · n: 2 · H₂ delivery: inhaled 2.5% hydrogen by nasal cannula for 4 to 5 hours three times a week during dialysis, for 3 months, added to electrolysed hydrogen dialysate (average 300 ppb)
- Comparator: none; the same patients' periods on hydrogen dialysate alone and on conventional dialysis
- Result: median SONG-HD fatigue 9 (conventional dialysis), 3 (hydrogen dialysate) and 0 (combined) in both patients. EQ-VAS 0, 30 and 100 (case 1) and 0, 35 and 100 (case 2). After return to conventional dialysis, fatigue 9 and EQ-VAS 0 again. Post-dialysis CitH3 8.48 to 1.58 ng/mL (case 1) and 6.71 to 4.32 ng/mL (case 2)
Source & links
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