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

Han-Hsing Tsou,Tsung-Yun Liu,Chih-Ching Lin,Chih-Kuang Liu,Szu-Yuan Li,Susan M. Pinney,Wen-Sheng Liu,Yen-Ting Lai,Hsiang-Lin Chan

doi:10.1371/journal.pone.0200271

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.

Highlights

Perfluorinated chemicals (PFCs) are used as surfactants in various industries and consumer products because of their unique properties as repellents of dirt, water and oils
We investigated the associations between PFCs and the clinical profile of uremic patients under hemodialysis (HD)
The most wellknown and widely used PFCs are perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS) and their derivatives belonging to the group of perfluoroalkylated substances

Summary

Introduction

Perfluorinated chemicals (PFCs) are used as surfactants in various industries and consumer products because of their unique properties as repellents of dirt, water and oils. The most wellknown and widely used PFCs are perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS) and their derivatives belonging to the group of perfluoroalkylated substances. These two PFCs comprise the majority of all PFCs and are potential toxic endocrine disruptors. In daily life, drinking water, air dust, food wrapping material and nonstick pans are all potential exposure routes for PFCs [4]. PFOA and PFOS are stable materials and resist photodegradation [5, 6]. Their half-lives after hydrolysis are longer than six months in the human body [7]

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Discussion

Conclusion