S8-4 Hydrogen sulphide in renal disease and transplantation

Abstract

Various beneficial actions of hydrogen sulfide have been shown in inflammatory, hypoxic and hypertensive condition. The kidney is a key organ in the regulation of various fysiological processes. Its delicate structure however makes it vulnerable for damage induced by inflammatory cells, reduction in oxygen and changes in blood pressure. H2S can protect against ischemia, reduced blood pressure and inflammatory cell influx and may therefore be a great candidate for renal therapies either as a single compound or as add-on medication. We have been using hydrogen sulfide administered either as a gas or injected as NaHS in ischemia/reperfusion and in Angiotensin II-induced nephrotic syndrome with promising results. One of the most promising strategies though comes from renal experiments in which we administrated thiosulfate, an endogenous donor of hydrogen sulfide. This compound has shown protective actions in experimental renal disease and can safely be used in humans. Moreover, in a human cohort of 707 transplant patients both sulfate and thiosulfate correlated inversely with cardiovascular outcome and predicted survival. Although these data ask for conformation in cohorts from healthy individuals as well, they hold great promise for the future. The great challenge that lies ahead of us relates to the human application of hydrogen sulfide compounds and the fundamental aspects on mechanism behind their protective actions in the kidney.