Dialysis Membranes Influence Perfluorochemical Concentrations and Liver Function in Patients on Hemodialysis

Abstract

Introduction: Perfluoro-octanesulfonate (PFOS) and perfluoro-octanoic acid (PFOA) are two toxic perfluorochemicals (PFCs) commonly used as surfactants. PFCs are difficult to be eliminated from the body. We investigated the influence of different dialysis membranes on the concentrations of PFCs in patients under hemodialysis. Method: We enrolled 98 patients. Of these, 58 patients used hydrophobic polysulfone (PS) dialysis membranes, and the other 40 had hydrophilic membranes made by poly-methyl methacrylate (PMMA) or cellulose triacetate (CTA). Liquid chromatography tandem mass spectrometry coupled was used with isotope dilution to quantify PFOA and PFOS. Results: The predialysis concentrations of PFOA and PFOS in patients with hydrophobic PS dialysis membranes were 0.50 and 15.77 ng/mL, respectively, lower than the concentrations of 0.81 and 22.70 ng/mL, respectively, in those who used hydrophilic membranes (such as CTA or PMMA). Older patients have higher PFOS and poorer body function, with lower Karnofsky Performance Status Scale (KPSS) scores. The demographic data of the two groups were similar. However, patients with hydrophobic PS dialysis membranes had lower predialysis aspartate transaminase (AST) (p = 0.036), lower glucose levels (p = 0.017), and better body function (nonsignificantly higher KPSS scores, p = 0.091) compared with patients who used other membranes. These differences may be associated with the effects of different membranes, because PFOA positively correlated with AST, while PFOS negatively correlated with body function. Conclusions: This is the first study comparing PFC levels in uremic patients with different dialysis membrane. PS membrane may provide better clearance of PFCs and may, therefore, be beneficial for patients.

Immunosenescence and Immune Exhaustion Are Associated with Levels of Protein-Bound Uremic Toxins in Patients on Hemodialysis

“…However, in our study, the PBUT levels in patients on HD did not have statistically significant correlations with the method of dialysis or membrane materials. In another study, it was found that dialysis membranes can have impacts on the levels of perfluorochemicals and could be helpful for patients [ 31 ].…”

Biological Utility of Fluorinated Compounds: from Materials Design to Molecular Imaging, Therapeutics and Environmental Remediation

“…To date, there is no proven method to accelerate the clearance of potentially toxic PFAS from the body. Although several strategies have been reported in the literature, including regular phlebotomy, intake of dietary fiber, and hemodialysis therapy, low removal efficiency, and specificity, are limitations. − One promising strategy reported by Genuis, Ducatman, and others is the use of a resin-binding drug cholestyramine (CSM). ,, CSM is a bile acid sequestrant (BAS) and has a long history of use for lipid control, is generally regarded as safe, and has been shown to be reasonably efficient for PFAS removal over an extended period of time, especially for PFOS. , Results indicated that ingestion of 4 g/day CSM in three doses for 20 weeks decreased the PFAS serum level compared to pretreatment (23.0 ng/g vs 14.4 ng/g, 5.9 vs 4.1 ng/g, and 58.0 vs 46.8 ng/g for PFOS, PFOA, and PFHxS, respectively) . These results are promising and indeed show accelerated clearance of PFAS in humans after treatment.…”

Strategies to Protect Dialysis Patients against Bisphenol A

“…Interestingly, a previous report by the same group demonstrated that the use of a BPA-free membrane (polynephron) decreased BPA concentrations in peripheral blood mononuclear cells in comparison to the use of a polysulfone membrane [ 26 ]. In this regard, it is unknown how these BPA-free filters could affect other endocrine disruptors (such as perfluorochemicals) [ 27 ].…”