Abstract

Dr. Kishore Kumar*

ABSTRACT

Chronic kidney disease is one of the major contributors of increased burden of non- communicable diseases worldwide with prevalence of 9.1% to 23%. Increased life expectancy and treatment development of Diabetes and Hypertension are leading contributors with increasing tendency to development of ESRD population need RRT (Renal replacement therapy) in the form of dialysis and transplant. Hemodialysis contributes to major part of RRT. Hemodialysis and CKD with ESRD and its causes are pro inflammatory conditions, which increase number of oxidative radicals and they activate a cascade of inflammation in human body. Inflammation ideally a protective mechanism of human body against any foreign invasion gets worse due to accumulation of oxidative radicals e.g., O-3 , -OH3 , IL6, IL1, TNF-?, FGF-? etc. Once this inflammatory cascade starts it get uncontrolled with time and results with some severe structural, hormonal, biochemical and hemostatic complication with resultant worse nightmare of many nephrologists due to uncontrolled B.P, blood sugar and Hemoglobin. Patients’ quality of life decreases, and one becomes dependent. To resolve this issue a prospective study was done by using mixture of active form of hydrogen contained steam (H(H2O)m) with nasal cannulas for three (3) hours session for three (3) days per week during hemodialysis at Renasense dialysis unit in Seychelles. Total 23 patients fulfilled inclusion criteria, 21 were on hemodialysis and two others, were studied. Major changes we focused were control of hypertension, diabetes, hemoglobin, and impact on quality of life. Out of 20 hypertensive patients initially 14 were using multiple drugs and 6 single drugs, after 6 months of continues therapy both diastolic and systolic blood pressures were well controlled and medicine quantity was minimized. Out of 6 diabetic patients, 4 were using OHGs and 2 were on insulin, after 6 months of treatment HBA1C stabilized at 6.5 to 7 and OHGs and insulin doses were reduced to stopped. Similarly, improvement in hemoglobin levels were also noticed and it was stabilized at 11 to 13mh/dl, at higher levels of Hb external erythropoietin administration was also reduced. Overall, with the continues treatment of H(H2O), quality of life in all participants became better and few of them were resumed their work and actively participated in community development. In this study we concluded that consecutive use of H(H2O)m for 3 months and more efficiently reduces oxidative stress and controls the inflammatory cascade with resultant improvement in quality of life by controlling metabolic, functional, and hormonal body parameters. Despite all satisfactory results, small number of participants and lack of prior awareness and reluctance to accept new therapy, were major limitations. So, we recommended to do a large population-based study and explore more potential effect of H(H2O)m to reduce increased oxidative stress in today’s world.