Associations between perfluorinated chemicals and serum biochemical markers and performance status in uremic patients under hemodialysis

• Published in: PloS one Vol. 13; no. 7; p. e0200271
• Main Authors: Liu, Wen-Sheng, Lai, Yen-Ting, Chan, Hsiang-Lin, Li, Szu-Yuan, Lin, Chih-Ching, Liu, Chih-Kuang, Tsou, Han-Hsing, Liu, Tsung-Yun
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 17-07-2018; Public Library of Science (PLoS)
• Subjects: Acids; Alkanesulfonic Acids - blood; Bans; Biochemical markers; Biology and Life Sciences; Biomarkers - blood; Caprylates - blood; Chemical properties; Chemicals; Child & adolescent psychiatry; Cholesterol; Chromatography; Chromatography, Liquid; Diabetes; Dialysis; Dilution; DNA methylation; Ecosystems; Female; Ferritin; Fluorocarbons - blood; Health risk assessment; Health sciences; Hemodialysis; Hospitals; Humans; Kidney diseases; Liquid chromatography; Male; Mass spectrometry; Mass spectroscopy; Medicine; Medicine and Health Sciences; Middle Aged; Nephrology; Organic chemistry; Patients; Perfluorocarbons; Perfluorooctanoic acid; Peritoneal dialysis; Physical Sciences; Proteins; Renal Dialysis; Research and Analysis Methods; Tandem Mass Spectrometry; Toxins; Treatment Outcome; Uremia - blood; Uremia - therapy; Urine; United States > US; Taiwan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0200271

Perfluorooctanesulfonate (PFOS) and perfluorooctanoic acid (PFOA) are commonly used perfluorinated chemicals (PFCs). PFCs are mainly excreted by urine. Uremic patients tend to accumulate toxins in their body and have poor functional status. We investigated the associations between PFCs and the clinical profile of uremic patients under hemodialysis (HD). Liquid chromatography tandem mass spectrometry coupled with isotope dilution was used to quantify PFOA and PFOS. We enrolled 126 patients under regular HD. Compared with previous research, the concentration of PFOA was lower, but that of PFOS was higher in uremic patients than in the general population. The levels of PFOA and PFOS in uremic patients before dialysis were 0.52 (ng/ml) and 21.84 (ng/ml) respectively. The PFOA level remained unchanged but that of PFOS decreased to1.85 ng/mL after dialysis. PFOS can be removed by HD. Patients using hypertensive medication had a lower PFOS then those who did not. The PFOS level was negatively correlated with the duration of the HD session and patient performance status, but positively correlated with levels of cholesterol, chloride (an indicator of acidemia), ferritin, and total protein. (p<0.05). The association with serum protein may explain the long half-life of PFCs in humans. This is the first study which investigated PFCs in uremic patients and showed PFCs are associated with adverse effects in this population.