Division of Nephrology, Department of Medicine, Taipei City Hospital, Zhongxing Branch, Taipei 10466, Taiwan.
School of Medicine, National Yang-Ming University, Taipei 10466, Taiwan.
Int J Environ Res Public Health. 2018 Nov 17;15(11):2574. doi: 10.3390/ijerph15112574.
: 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. : 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. : 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) ( = 0.036), lower glucose levels ( = 0.017), and better body function (nonsignificantly higher KPSS scores, = 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. : 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.
全氟辛烷磺酸 (PFOS) 和全氟辛酸 (PFOA) 是两种常用作表面活性剂的有毒全氟化学品 (PFC)。PFC 很难从体内消除。我们研究了不同透析膜对血液透析患者体内 PFC 浓度的影响。
我们纳入了 98 名患者。其中，58 名患者使用疏水性聚砜 (PS) 透析膜，另 40 名患者使用由聚甲基丙烯酸甲酯 (PMMA) 或纤维素三乙酸酯 (CTA) 制成的亲水性膜。采用液相色谱串联质谱联用同位素稀释法对 PFOA 和 PFOS 进行定量。
使用疏水性 PS 透析膜的患者的透析前 PFOA 和 PFOS 浓度分别为 0.50 和 15.77ng/mL，低于使用亲水性膜（如 CTA 或 PMMA）的患者的浓度（分别为 0.81 和 22.70ng/mL）。年龄较大的患者 PFOS 水平较高，身体功能较差，卡诺夫斯基绩效状态评分 (KPS) 较低。两组的人口统计学数据相似。然而，与使用其他膜的患者相比，使用疏水性 PS 透析膜的患者的透析前天门冬氨酸转氨酶 (AST) 较低（=0.036），血糖水平较低（=0.017），身体功能更好（KPS 评分略高，=0.091）。这些差异可能与不同膜的作用有关，因为 PFOA 与 AST 呈正相关，而 PFOS 与身体功能呈负相关。
这是第一项比较不同透析膜尿毒症患者体内 PFC 水平的研究。PS 膜可能对 PFC 的清除效果更好，因此对患者有益。
