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Hydrogen Sulfide as a Potential Future Therapy for Chronic Kidney Disease, Hyperhomocysteinemia, and Management of Polycystic Kidney Disease

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Hydrogen Sulfide in Kidney Diseases

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Abstract

Chronic kidney disease (CKD) is a common global health challenge characterized by irreversible pathological processes that reduce kidney function and culminate in the development of end-stage renal disease. It is associated with increased morbidity and mortality in addition to increased caregiver burden and higher financial cost. A central player in CKD pathogenesis and progression is renal hypoxia. Renal hypoxia stimulates induction of oxidative and endoplasmic reticulum stress, inflammation, and tubulointerstitial fibrosis, which in turn promote cellular susceptibility and further aggravate hypoxia, thus forming a pathological vicious cycle in CKD progression. Although the importance of CKD is widely appreciated, including improvements in the quality of existing therapies such as dialysis and transplantation, new therapeutic options are limited, as there is still increased morbidity, mortality, and poor quality of life among CKD patients. Growing evidence indicates that hydrogen sulfide (H2S), a small gaseous signaling molecule with an obnoxious smell, accumulates in the renal medulla under hypoxic conditions and functions as an oxygen sensor that restores oxygen balance and increases medullary flow. Moreover, plasma H2S level has been recently reported to be markedly reduced in CKD patients and animal models. Also, H2S has been established to possess potent antioxidant, anti-inflammatory, and anti-fibrotic properties in several experimental models of kidney diseases, suggesting that its supplementation could protect against CKD and retard its progression. The purpose of this chapter is to discuss current clinical and experimental developments regarding CKD, its pathophysiology, and potential cellular and molecular mechanisms of protection by H2S in experimental models of CKD. A section of the chapter also discusses hyperhomocysteinemia and autosomal dominant polycystic kidney disease, which are forms of CKD, and H2S as an additional/alternative agent for pharmacological treatment or management of these conditions.

This chapter is an expanded version by the same author in the publication titled The smell of renal protection against chronic kidney disease: hydrogen sulfide offers a potential stinky remedy. Pharmacol Rep. 2018;70(2):196–205.

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Authors and Affiliations

  1. Department of Pharmacology and Toxicology, School of Pharmacy, College of Health Sciences, University of Ghana, Accra, Ghana

    George J. Dugbartey

  2. Department of Physiology and Pharmacology, Accra College of Medicine, Accra, Ghana

    George J. Dugbartey

  3. Division of Urology, Department of Surgery, London Health Sciences Center, Western University, London, ON, Canada

    George J. Dugbartey

  4. Multi-Organ Transplant Program, London Health Sciences Center, Western University, London, ON, Canada

    George J. Dugbartey

  5. Matthew Mailing Center for Translational Transplant Studies, London Health Sciences Center, Western University, London, ON, Canada

    George J. Dugbartey

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  1. George J. Dugbartey
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Correspondence to George J. Dugbartey .

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Dugbartey, G.J. (2023). Hydrogen Sulfide as a Potential Future Therapy for Chronic Kidney Disease, Hyperhomocysteinemia, and Management of Polycystic Kidney Disease. In: Hydrogen Sulfide in Kidney Diseases. Springer, Cham. https://doi.org/10.1007/978-3-031-44041-0_3

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  • DOI: https://doi.org/10.1007/978-3-031-44041-0_3

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  • Online ISBN: 978-3-031-44041-0

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