Hyperbaric Oxygen Therapy for Diabetic Nephropathy

Diabetic nephropathy is considered the most common chronic microvascular complication of diabetes. Its pathophysiology is closely related to long-standing metabolic alterations that result in anatomical and functional changes at the glomerular level that are directly related to its pathogenesis and natural course.

Hyperbaric oxygen therapy could be a unique therapeutic strategy for patients with diabetic nephropathy, restoring renal function by repairing damaged tissues and inhibiting the pathological processes associated with chronic kidney disease.

A 2020 study by Mexican scholars confirmed that 20 sessions of hyperbaric oxygen-assisted therapy reduced urinary albumin levels, improved glomerular filtration rate, and halted the progression of chronic kidney disease in patients with stage 3 and 4 diabetic nephropathy, leading to a further improvement in their clinical stage, compared with conventional therapy and normobaric air alone.

Patient information

A total of 15 individuals participated in the study, 8 in the hyperbaric oxygen therapy group and 7 in the control group.

The two groups were matched for clinical characteristics, and there were no statistical differences between the two groups in terms of body mass index, history of diabetes mellitus, glycosylated hemoglobin, glomerular filtration rate, or urinary albumin/creatinine, as shown in the table below.

Conventional treatment

Four patients (50%) in the hyperbaric group were being treated with angiotensin-converting enzyme inhibitors, whereas only two patients (28.6%) in the control group were receiving such medication. All other participants were receiving angiotensin II receptor blocker therapy.

Hyperbaric Oxygen

Hyperbaric oxygen group: steady-pressure oxygen for 60 minutes, once a day, 5 times a week for a total of 20 times.

The results of the study showed that patients with diabetes mellitus combined with diabetic nephropathy treated with hyperbaric oxygen resulted in improved renal function as evidenced by improved urinary albumin/creatinine ratio and glomerular filtration rate. The hyperbaric oxygen group showed improvement in urinary creatinine ratio and glomerular filtration rate, which decreased by 39.7% and increased by 25.9%, respectively, compared with the control group, whose conventional diabetes medication, diet, and hypertension medication reflected the natural progression of chronic kidney disease.

In terms of clinical analysis, 50% of patients in the hyperbaric oxygen group saw improvement at the end of the study, while the rest did not. In the control group, most of the patients who received normobaric oxygen experienced more kidney damage.

Various clinical studies have demonstrated that hyperbaric oxygen is successful in the treatment of the diabetic foot, especially in Wagner grade 3 and 4 ulcers. Harrison et al. demonstrated that hyperbaric oxygen therapy has metabolic, tissue, and cellular effects such as improved repair processes, renal toxin metabolism, mitochondrial function,n and antioxidant stimulation. Experimental results suggest that when hyperbaric oxygen is given, it has the potential to halt the progression of chronic kidney disease and even improve glomerular filtration rate and renal function. In animal models, hyperbaric oxygen has cellular and tissue effects. This provides a basis for hypotheses about the potential benefits of hyperbaric oxygen therapy in reducing or reversing injury in chronic kidney disease. In addition, hyperbaric oxygen therapy may be beneficial in the treatment of diabetic foot.

Diabetes mellitus is a major killer of elderly people's lives and health, especially the complications caused by it have claimed many elderly people's lives. The diabetic foot mentioned in this article is a serious complication of diabetes mellitus, which is one of the most important reasons for diabetes mellitus patients to become disabled, or even fatal. Common diabetes treatments include insulin injections, oral hypoglycemic drugs, and dietary control etc. If hyperbaric oxygen therapy is combined with this treatment, the results will be even better.