Malahayati International Journal of Nursing and Health Science
Vol. 9 No. 4 (2026): Volume 9 Number 4

The effect of carbon dioxide water immersing on inflammation biomarker in patients with chronic kidney disease undergoing hemodialysis

Yammar Yammar (Fakultas Ilmu Kesehatan, Universitas Puangrimaggalatung)
Annisa Suwahru (Program Studi Terapi Gigi, Fakultas Ilmu Kesehatan, Universitas Sulawesi Barat)
Andi Rizky Arbaim Hasyar (Program Studi Fisioterapi, Fakultas Kedokteran, Universitas Hasanuddin)
Irfan Idris (Program Studi Fisioterapi, Fakultas Kedokteran, Universitas Hasanuddin)
Irawan Yusuf (Program Studi Fisioterapi, Fakultas Kedokteran, Universitas Hasanuddin)
Haerani Rasyid (Divisi Nefrologi-Hipertensi, Program Studi Ilmu Penyakit Dalam, Universitas Hasanuddin)
Barangkau Barangkau (Program Studi Keperawatan, Fakultas Ilmu Kesehatan, Universitas Puangrimaggalatung)



Article Info

Publish Date
26 Jun 2026

Abstract

Background: Chronic kidney disease (CKD) patients undergoing hemodialysis (HD) often exhibit elevated levels of ICAM-1 and VCAM-1, key biomarkers of inflammation, and are prone to microcirculatory dysfunction. Recent evidence suggests that carbon dioxide (CO₂)-rich water immersion may enhance microcirculation, yet its impact on inflammatory biomarkers in CKD patients on HD remains unclear. Purpose: To evaluate the effect of CO₂-rich water immersion on ICAM-1 and VCAM-1 levels in CKD patients receiving HD. Method: This experimental study involved 22 CKD patients randomized into two groups: 14 received CO2-rich water immersion and 8 received freshwater immersion. CO2-rich water was generated using JESC CREABC-2000, with both immersions maintained at 37–38°C. Patients immersed both legs for 10 minutes, 2–3 times weekly for one month, prior to HD sessions. Blood samples were collected on day 1 and day 28. Data were analyzed using the Wilcoxon test, with statistical significance set at P < 0.05. Results: After one month, ICAM-1 and VCAM-1 levels decreased in the CO2-rich water group (42.895±58.833 to 39.690±41.911 ng/mL, P=0.650; 140.520±177.43 to 96.170±30.17 ng/mL, P=0.917). Conversely, levels increased in the freshwater group (ICAM-1: 38.642±40.975 to 63.978±80.659 ng/mL, P=1.000; VCAM-1: 100.430±34.89 to 131.920±59.80 ng/mL, P=0.461). Conclusion: CO2-rich water immersion tended to reduce ICAM-1 and VCAM-1 levels in CKD patients undergoing HD, although the changes were not statistically significant. These findings suggest potential anti-inflammatory effects warranting further investigation with larger cohorts.

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Journal Info

Abbrev

minh

Publisher

Subject

Health Professions Nursing Public Health

Description

Malahayati International Journal of Nursing and Health Science is a peer-reviewed journal and provides a platform to publish areas of nursing and health science. The journal also seeks to advance the quality of research by publishing papers introducing or elaborating on new methods in nursing and ...