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

PLoS One. 2018 Jul 17;13(7):e0200271. doi: 10.1371/journal.pone.0200271. eCollection 2018.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Alkanesulfonic Acids / blood*
  • Biomarkers / blood
  • Caprylates / blood*
  • Chromatography, Liquid
  • Female
  • Fluorocarbons / blood*
  • Humans
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Tandem Mass Spectrometry
  • Treatment Outcome
  • Uremia / blood*
  • Uremia / therapy

Substances

  • Alkanesulfonic Acids
  • Biomarkers
  • Caprylates
  • Fluorocarbons
  • perfluorooctanoic acid
  • perfluorooctane sulfonic acid

Grants and funding

This study was supported by Taipei Veteran General Hospital (Grant No 201010007IC) and Taipei City Hospital (Grant No TPCH-103-028 & 10401-62-039). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.