Molecular hydrogen: prospective treatment strategy of kidney damage after cardiac surgery

• Published in: Canadian journal of physiology and pharmacology 2023-10, Vol.101 (10), p.502-508
• Main Authors: Kalocayova, Barbora, Kura, Branislav, Vlkovicova, Jana, Snurikova, Denisa, Vrbjar, Norbert, Frimmel, Karel, Hudec, Vladan, Ondrusek, Matej, Gasparovic, Ivo, Sramaty, Rastislav, Luptak, Jaroslav, Hulman, Michal, LeBaron, Tyler W, Slezak, Jan
• Format: Article
• Language: English
• Subjects: Anesthesia; Biomarkers; Care and treatment; Causes of; Complications; Creatinine; Health aspects; Heart; Heart surgery; Hydrogen; Inhalation; Kidney diseases; Kidneys; Oxidative stress; Postoperative; Proteins; Reperfusion; Superoxide dismutase; Surgery; Transplantation
• ISSN: 0008-4212; 1205-7541; 1205-7541
• DOI: 10.1139/cjpp-2023-0098

Cardiac surgery-associated acute kidney injury (CS-AKI) is a common postoperative complication, mostly due increasing oxidative stress. Recently, molecular hydrogen (H2 gas), has also been applied to cardiac surgery due to its ability to reduce oxidative stress. We evaluated the potential effect of H2 application on the kidney in an in vivo model of simulated heart transplantation. Pigs underwent cardiac surgery with 3 hours while connected to extracorporeal circulation (ECC) and subsequent 60 minutes of spontaneous reperfusion of the heart. We used two experimental groups: T - pigs after transplantation, TH - pigs after transplantation treated with 4% H2 mixed with air during inhalation of anesthesia and throughout oxygenation of blood in ECC. The levels of creatinine, urea and phosphorus were measured in plasma. Renal tissue samples were analyzed by Western blot method for protein levels of Nrf2, Keap-1, and SOD1. After cardiac surgery, selected plasma biomarkers were elevated. However, H2 therapy was followed by the normalization of all these parameters. Our results suggest activation of Nrf2/Keap1 pathway as well as increased SOD1 protein expression in the group treated with H2. The administration of H2 had a protective effect on the kidneys of pigs after cardiac surgery, especially in terms of normalization of plasma biomarkers to control levels.