Influence of dialysis membrane composition on plasma bisphenol A levels during online hemodiafiltration

Abstract

IntroductionBisphenol A (BPA) is an ubiquitous environmental toxin that is also found in dialyzers. Online hemodiafiltration (OL-HDF) more efficiently clears high molecular weight molecules, and this may improve BPA clearance. However, the BPA contents of dialysis membranes may be a source of BPA loading during OL-HDF.MethodsA prospective study assessed plasma BPA levels in OL-HDF patients using BPA-free (polynephron) or BPA-containing (polysulfone) dialyzers in a crossover design with two arms, after a run-in OL-HDF period of at least 6 months with the same membrane: 31 patients on polynephron at baseline were switched to polysulfone membranes for 3 months (polynephron-to-polysulfone) and 29 patients on polysulfone were switched to polynephron for 3 months (polysulfone-to-polynephron).ResultsAfter a run-in OL-HDF period of at least 6 months with the same membrane, baseline pre-dialysis BPA was lower in patients on polynephron (8.79±7.97 ng/ml) than in those on polysulfone (23.42±20.38 ng/mL, p<0.01), but still higher than in healthy controls (<2 ng/mL). After 3 months of polynephron-to-polysulfone switch, BPA was unchanged (8.98±7.88 to 11.14±15.98 ng/mL, ns) while it decreased on the polysulfone-to-polynephron group (23.42±20.38 to 11.41±12.38 ng/mL, p<0.01).ConclusionOL-HDF for 3 months with BPA-free dialyzer membranes was associated to a significant decrease in predialysis BPA levels when compared to baseline BPA levels while on a BPA-containing membrane.

Bisphenol A impaired cell adhesion by altering the expression of adhesion and cytoskeleton proteins on human podocytes

“…Although no effect was observed at lower BPA concentration, this finding is relevant because such concentration can usually be found in people whose jobs have high exposure to BPA, such as the plastics or thermal papers industry 25 – 27 . Furthermore, it has been shown that higher concentrations can be found in patients with kidney disease in advanced stages undergoing hemodialysis 44 , 45 , as well as in neonates undergoing surgical interventions where BPA levels can be even higher 46 .…”

“…It has been described that the general population has a concentration of BPA that ranges between 1 and 10 nM, while workers with high exposure to BPA can reach a concentration of 100 nM [73][74][75] . Furthermore, it has been described that surgical interventions or hemodialysis in the hospital environment can increase the exposure to BPA even more [44][45][46] .…”

Presence of Bisphenol A and Parabens in a Neonatal Intensive Care Unit: An Exploratory Study of Potential Sources of Exposure

“…2001; Murakami et al. 2007), and plasma BPA levels were lower in hemodialysis patients using polynephron (BPA-free) versus conventional polysulfone dialyzer membranes (Mas et al. 2018).…”

Overexposure to Bisphenol A and Its Chlorinated Derivatives of Patients with End-Stage Renal Disease during Online Hemodiafiltration

“…Hence, the metabolism, tissue distribution, and elimination from the body remains unclear and no-TDI has been established for these compounds. Recent studies affirm that OL-HDF could reduce BPA blood levels in dialyzed patients [42,43]. However, the methodology used raises some questions since the number of patients was low, and some issues regarding the analytical method used.…”