Panda Sanjay Kumar, Maloth Rama Krishna, Upadyayalu Vijayasarthi, Mishra Ankita, Noronha Santosh
Department of Nephrology, Base Hospital Delhi Cantt, New Delhi, India.
Department of Analytical and Structural Chemistry, CSIR-Indian Institute of Chemical Technology, Hyderabad, Tarnaka, India.
Indian J Nephrol. 2025 Jan-Feb;35(1):34-39. doi: 10.25259/ijn_515_23. Epub 2024 Jul 1.
Peritoneal dialysis (PD) is an important modality of renal replacement therapy (RRT). Peritonitis and ultrafiltration failure are complications that have a long-term impact on PD patients. Besides touch contamination, procedural errors and clinical reasons of peritonitis, contaminants, and constituents of peritoneal dialysis fluids (PDFs) have been implicated in causing peritonitis and ultrafiltration failure. This study was aimed to test the PDFs in India for the presence of migratory plastics.
PDFs from the two manufacturers in India were tested using liquid chromatography mass spectrometry (LCMS) and gas chromatography mass spectrometry (GCMS) with headspace analysis (volatile compounds) and pyrolysis of plastics (polymer compounds). The storage conditions and handling were uniform.
The results revealed impurities of acetate compounds and aldehyde derivatives of glucose degradation products (GDPs) with contaminants and leachable plastics. There were high levels of GDP derivative in the form of 5-hydroxymethylfurfural compounds (5-HMF). The analysis revealed the presence of plastic softeners in very high concentrations.
The study unmasks the presence of chemicals and GDPs that can be implicated in pathogenesis of sterile peritonitis and ultrafiltration failure. The study demonstrated the presence of leachable plastics. In conclusion, LCMS and GCMS studies can be used to test PDFs for unwanted chemicals prior to human use.
腹膜透析（PD）是肾脏替代治疗（RRT）的一种重要方式。腹膜炎和超滤失败是对腹膜透析患者有长期影响的并发症。除了接触污染、操作失误以及腹膜炎的临床原因外，腹膜透析液（PDFs）中的污染物和成分也被认为与腹膜炎和超滤失败的发生有关。本研究旨在检测印度的腹膜透析液中是否存在迁移性塑料。
使用液相色谱 - 质谱联用仪（LCMS）和气相色谱 - 质谱联用仪（GCMS）对印度两家制造商生产的腹膜透析液进行检测，采用顶空分析（挥发性化合物）和塑料热解（聚合物化合物）。储存条件和处理方式保持一致。
结果显示存在醋酸盐化合物杂质以及葡萄糖降解产物（GDPs）的醛衍生物，伴有污染物和可浸出塑料。以5 - 羟甲基糠醛化合物（5 - HMF）形式存在的GDP衍生物含量很高。分析还发现存在高浓度的塑料软化剂。
该研究揭示了可能与无菌性腹膜炎和超滤失败发病机制有关的化学物质和GDPs的存在。研究证明了可浸出塑料的存在。总之，在人类使用前，LCMS和GCMS研究可用于检测腹膜透析液中是否存在有害化学物质。
