腹膜透析液の革新：生体適合性製剤と適応拡大に関するレビュー
Peritoneal dialysis (PD) serves as a key renal replacement modality for end-stage kidney disease, yet its long-term use is hampered by peritoneal fibrosis and metabolic disturbances arising from conventional glucose-based dialysis fluids. This review examines three categories of innovation aimed at overcoming these challenges: novel osmotic agents including L-carnitine and hyperbranched polyglycerol, advanced buffering systems using citrate and pyruvate, and peritoneal-protective additives such as glycosaminoglycans and molecular hydrogen. Molecular hydrogen is highlighted for its capacity to reduce fibrosis and preserve membrane integrity. The review also proposes hybrid formulations combining osmotic agents, buffers, and additives to achieve synergistic protection. Additionally, the application of PD in refractory heart failure is discussed, where specialized fluid protocols improved ultrafiltration efficiency and addressed volume overload in cardiorenal syndrome, suggesting a broader systemic role for PD beyond renal replacement.
Molecular hydrogen is proposed to selectively scavenge reactive oxygen species, thereby suppressing peritoneal fibrosis and preserving membrane function during dialysis.
The delivery route is not clearly identifiable from this paper. For hydrogen intake, inhalation is the most efficient route; inhalation, however, carries explosion risk (empirical LFL of 10%; high-concentration devices are not recommended).
See also:
https://h2-papers.org/en/papers/41285129