Dialysate With High Dissolved Hydrogen Facilitates Dissociation of Indoxyl Sulfate From Albumin

BACKGROUND: Protein-bound toxins such as indoxyl sulfate (IS) are not efficiently removed by conventional hemodialysis (HD). OBJECTIVES: To improve the removal of IS, we performed an in vitro study to evaluate the effects of high dissolved hydrogen on the dissociation of IS from albumin using simulated HD. MATERIALS AND METHODS: Wasted dialysate from peritoneal dialysis was concentrated a hundred times using extracorporeal ultrafiltration method. Dialysate with high dissolved hydrogen was made by mixing concentrated dialysis solution and electrolyzed-reduced water. The amounts of free fractions of IS were determined by high performance liquid chromatography. RESULTS: IS was significantly dissociated from albumin using dialysate with high dissolved hydrogen compared with conventional dialysate (P < 0.05). CONCLUSIONS: Effective removal of IS is expected using a dialysate with high dissolved hydrogen.