Determination of Plasticizer Levels in Serum of Hemodialysis Patients

Lm, Lewis; Tw, Flechtner; Kerkay, Julius; Kh, Pearson; Wt, Chen; Kl, Popowniak; Nakamoto, Satoru

doi:10.1097/00002480-197700230-00152

Cited by 17 publications

(4 citation statements)

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“…This observation documents that acetate may contribute to the elevation of serum triglyc erides in hemodialysis patients. DEHP, a plasticizer which is used in the tubing of hemodialyzers, has been shown to cause hypolipemia and to reduce lipid metabolism in various tissues [30,31], Whether these experimental ob servations are relevant for the lipid abnormality in hemodialyzed patients remains to be shown; no correlation be tween serum triglycerides and the plasma levels of plas ticizer was found in the study by Lewis et al [32]. Ad ministration of aluminium hydroxide, another common modality of therapy in dialyzed patients, may have effects on serum lipids.…”

Section: Lipid and Lipoprotein Patterns In Uremiamentioning

confidence: 98%

Hyperlipoproteinemia in Renal Insufficiency

Heuck

Ritz²

1980

Nephron

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In uremic patients, hyperlipoproteinemia is common, but its role as a risk factor in atherogenesis remains controversial. The main abnormality appears to be diminished catabolism of lipoproteins in the face of unchanged or low hepatic synthesis. The relation of diminished catabolism to reduced postheparin lipolytic activity and selective deficiency of hepatic triglyceride lipase remains to be established. Hyperlipoproteinemia in uremic patients, most commonly of the type IV variety, responds to dietary methods (reduction of carbohydrate content, increase in P/S ratio) or pharmacological intervention. Guidelines for therapy remain controversial in view of the uncertainty about the pathogenic role of hyperlipoproteinemia in atherogenesis.

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Section: Lipid and Lipoprotein Patterns In Uremiamentioning

confidence: 98%

Hyperlipoproteinemia in Renal Insufficiency

Heuck

Ritz²

1980

Nephron

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“…Since 1970, a series of studies have identi®ed and measured DEHP or its metabolites in human tissue and serum of patients receiving dialysis, blood transfusions, arti®cial ventilation, and exchange transfusions [Jaeger and Rubin 1970;Hillman et al, 1975;Lewis et al, 1978;Kevy and Jacobson, 1982;Ganning et al, 1984;Roth et al, 1988;Sjoberg et al, 1985aSjoberg et al, , 1985b.…”

Section: Medical Exposuresmentioning

confidence: 99%

Health risks posed by use of Di-2-ethylhexyl phthalate (DEHP) in PVC medical devices: A critical review

et al. 2001

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Background Polyvinyl chloride plastics (PVC), made flexible through the addition of di‐2‐ethylhexyl phthalate (DEHP), are used in the production of a wide array of medical devices. From the late 1960s, leaching of DEHP from PVC medical devices and ultimate tissue deposition have been documented. Methods A critical review of DEHP exposure, metabolism, and toxicity data from human and animals studies was undertaken. A brief analysis of alternatives to DEHP‐plasticized PVC for use in medical device manufacture was completed. Results DEHP leaches in varying concentrations into solutions stored in PVC medical devices. Certain populations, including dialysis patients and hemophiliacs may have long‐term exposures to clinically important doses of DEHP, while others, such as neonates and the developing fetus, may have exposures at critical points in development. In vivo and in vitro research links DEHP or its metabolites to a range of adverse effects in the liver, reproductive tract, kidneys, lungs, and heart. Developing animals are particularly susceptible to effects on the reproductive system. Some adverse effects in animal studies occur at levels of exposure experienced by patients in certain clinical settings. DEHP appears to pose a relatively low risk of hepatic cancer in humans. However, given lingering uncertainties about the relevance of the mechanism of action of carcinogenic effects in rodents for humans and interindividual variability, the possibility of DEHP‐related carcinogenic responses in humans cannot be ruled out. Conclusions The observed toxicity of DEHP and availability of alternatives to many DEHP‐containing PVC medical devices presents a compelling argument for moving assertively, but carefully, to the substitution of other materials for PVC in medical devices. The substitution of other materials for PVC would have an added worker and community health benefit of reducing population exposures to DEHP, reducing the creation of dioxin from PVC production and disposal, and reducing risks from vinyl chloride monomer exposure. Am. J. Ind. Med. 39:100–111, 2001. © 2001 Wiley‐Liss, Inc.

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“…Unfortunately, modifications were subsequently introduced that worsened the procedure ; for example, the use of only one tube to collect and reinfuse the blood (involving the risk of a clot formation and the disadvantage of an imperfect mixing of blood with gas) and even worse, since 1991 in Italy, the substitution of neutral glass bottles, perfectly ozone-resistant, with plastic bags allowed only for blood storage because they are cheaper and easier to stow away. These bags are made of about 55% polyvinyl chloride (PVC) mixed with a number of additives, among which about 43% of phthalates (Valeri et al, 1973 ; Lewis et al, 1977 ; Lawrence, 1978 ; Thomas et al, 1978 ; Callahan et al, 1982 ; Labow et al, 1986 ; Whysner et al, 1996 ). These compounds make the PVC elastic but a minimal amount of phthalates is released into blood.…”

Section: Major Ozone Autohaemotherapy (Aht)mentioning

confidence: 99%