Kanowski Solveig, Shen Yuanhao, Klein Till, Moeller Marcus J, Koch Andreas, Theilig Franziska
Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.
Institute of Anatomy, Christian-Albrechts-University Kiel, Otto-Hahn-Platz 8, 24118, Kiel, Germany.
Sci Rep. 2025 Jul 11;15(1):25143. doi: 10.1038/s41598-025-10569-y.
Hyperbaric Oxygenation Therapy (HBOT) is a widely used therapeutic option. It involves cycles with administration of 100% oxygen at increased atmospheric pressure to enhance oxygen delivery to tissues. The application of HBOT may affect all organs and tissues including kidneys which may be sensitive to the changes during HBOT. As underlying mechanisms for HBOT, the production of reactive oxygen species including superoxide, antioxidant reactions, increased plasma levels of growth factors and nuclear hypoxia-inducible factor-1α (HIF-1α) expression are discussed. Although HBOT is frequently used in man, knowledge about effects of HBOT on kidney function is still lacking in humans. The aim of this pilot study was to monitor changes in renal function parameters, including hypoxia inducible factor 1α (HIF-1α) and erythropoietin and employing urinary EV´s to document renal alterations. Test persons (n = 23) enrolled presented healthy renal status and received 10 HBOT sessions. Blood and urine samples were taken at the first, the fifth and the tenth HBOT session. Heart rate decreased during HBOT in male and female test persons which may be due to a stimulation of vagal nerve activity. Serum HIF-1α and erythropoietin values, blood pressure, blood and urine values for renal function parameter except for urine osmolality remained unaffected by HBOT. Urine osmolality together with the trend of renal Na/K/2Cl-cotransporter expression on isolated urinary extracellular vesicles during HBOT significantly increased in both female in male test persons. Most likely, the generation of superoxide may account for the trend in the augmented renal NKCC2 expression and urine osmolality. HIF-1α downstream targets including renal sodium transporter affected by HIF-1α alteration remained unchanged suggesting the relative hypoxia after end of HBOT may not be sufficient. Overall, renal function upon HBOT remained largely unaffected with only minor alterations in urine osmolality.
高压氧疗法（HBOT）是一种广泛应用的治疗方法。它包括在增加的大气压下给予100%氧气的周期，以增强氧气向组织的输送。HBOT的应用可能会影响所有器官和组织，包括对HBOT期间变化敏感的肾脏。作为HBOT的潜在机制，讨论了活性氧的产生，包括超氧化物、抗氧化反应、血浆生长因子水平的增加以及核缺氧诱导因子-1α（HIF-1α）的表达。尽管HBOT在人类中经常使用，但关于HBOT对肾功能影响的知识在人类中仍然缺乏。这项初步研究的目的是监测肾功能参数的变化，包括缺氧诱导因子1α（HIF-1α）和促红细胞生成素，并利用尿液细胞外囊泡记录肾脏改变。招募的测试对象（n = 23）呈现健康的肾脏状态，并接受10次HBOT治疗。在第一次、第五次和第十次HBOT治疗时采集血液和尿液样本。男性和女性测试对象在HBOT期间心率下降，这可能是由于迷走神经活动受到刺激。血清HIF-1α和促红细胞生成素值、血压以及除尿渗透压外的肾功能参数的血液和尿液值均未受HBOT影响。在男性和女性测试对象中，HBOT期间尿渗透压以及分离的尿液细胞外囊泡上肾钠/钾/2氯共转运蛋白表达的趋势均显著增加。最有可能的是，超氧化物的产生可能是肾NKCC2表达增加和尿渗透压升高趋势的原因。受HIF-1α改变影响的HIF-1α下游靶点，包括肾钠转运体，保持不变，这表明HBOT结束后的相对缺氧可能不够充分。总体而言，HBOT后的肾功能基本未受影响，只有尿渗透压有轻微改变。
