Abstract: SA-PO762

Influence of Dialysis Membranes on Bisphenol A Serum Levels in Online Hemodiafiltration

Session Information

Category: Dialysis

  • 601 Standard Hemodialysis for ESRD

Authors

  • Mas, Sebastian, IIS-FJD, Madrid, Spain
  • Bosch, Enrique, IIS- FJD, Madrid, Spain
  • Ruiz, Alberto, IIS- FJD, Madrid, Spain
  • Civantos, Esther, IIS- FJD, Madrid, Spain
  • Egido, Jesus, Fundacion Jimenez Diaz, Madrid, Spain
  • Ortiz, Alberto, Fundacion Jimenez Diaz, Madrid, Spain
  • Gonzalez-parra, Emilio E., Fundacion Jimenez Diaz, Madrid, Spain
Background

In uremia, the environmental toxin Bisphenol A (BPA) accumulates bound to proteins. BPA-containing dialyzers contribute to increase plasma BPA concentration in conventional hemodialysis patients. Online hemodiafiltration (OL-HDF) more efficiently clears high molecular weight molecules, and this may improve BPA clearance. However, OL-HDF requires high infusion volumes of replacement fluid generated online by using BPA-containing membranes and, thus, can be a source of BPA load.

Objectives:To assess plasma BPA levels in OL-HDF patients using BPA-free or BPA-containing dialyzers.

Methods

In a prospective study, plasma BPA was assessed at baseline and 3 months after switching from baseline BPA-free polynephron to BPA-containing polysulfone (n=31) dialyzers, or from baseline polysulfone to polynephron (n=27) dialyzers in OL-HDF patients. Results were compared to a prior study on conventional hemodialysis.

Results

OL-HDF patients had lower plasma BPA than those in conventional hemodialysis (12.12±15.91 vs. 64.55±93.8 ng/mL) and both were several fold higher than healthy controls (<2 ng/ml). However, this was influenced by the dialysis membrane. Thus, baseline BPA was 8.79±7.97 ng/ml in patients dialyzed ≥6 months with polynephron versus 23.42±20.38 ng/mL with polysulfone. During the first single OL-HDF session with the switch membrane, BPA decreased in the polysulfone-to-polynephron group (pre-dialysis 23.42±20.38 ng/ml to post-dialysis 6.44±10.77 ng/mL, p <0.01), but remained unchanged in polynephron-to-polysulfone patients. After 3 months on polysulfone, BPA levels rose non-significantly from 8.79±7.97 to 11.02±16.17 ng/mL in the polynephron-to-polysulfone group, while they decreased 51% in the polysulfone-to-polynephron group (p<0.01).

Conclusion

Optimal reduction in BPA levels is achieved by using OL-HDF with BPA-free dialyzer membranes. Attempts at optimizing net BPA clearance in OL-HDF are justified by the residual higher plasma BPA levels when compared to healthy controls.

Funding

  • Commercial Support