Publication: Contribución del Bisfenol a (BPA) en la inflamación y oxidación en el paciente de hemodiálisis
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2017-09-11
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Universidad Complutense de Madrid
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Abstract
El bisfenol A (BPA) es un componente de algunas membranas de diálisis, que se acumula en la Enfermedad Renal Cronica (ERC). Estudios observacionales han demostrado que la exposición de BPA está vinculado a la lesión renal y cardiovascular en los seres humanos, y en estudios en animales se han descrito un nexo causal. Los riñones con función renal normal excretan rápidamente BPA, pero una excreción insuficiente en pacientes con ERC da lugar a la acumulación del BPA en el organismo. Utilizando un diseño cruzado, se estudió el efecto de la hemodiálisis con membranas de polisulfona (contienen BPA) y el uso de dializadores de polinefrona (sin BPA en su composición) en los niveles de BPA en 69 pacientes prevalentes en hemodiálisis: 28 pacientes iniciaron la diálisis con membranas de polisulfona durante tres meses y fueron cambiados a membranas de polinefrona durante otros tres meses. La misma metodología fue para los 41 pacientes que iniciaron la diálisis con membranas de polinefrona y transcurrido un periodo de tres meses fueron cambiados a membranas de polisulfona. Los resultados fueron agrupados para su análisis. La media de los niveles de BPA aumentó después de una sesión de hemodiálisis con dializadores de polisulfona pero no con dializadores polinefrona. El uso crónico (3 meses) de dializadores de polisulfona incrementó no de forma significativa los niveles de BPA en suero en la prediálisis, aunque presenta una tendencia a aumentar (de 48.8±6.8 69.1±10.1 ng / ml). El uso crónico de dializadores con polinefrona disminuyó los niveles de BPA en suero previo a la diálisis (de 70.6±8.4 a 47.1±7.5 ng / ml, P<0,05). El BPA intracelular en PBMCs aumentó después de la hemodiálisis crónica con membranas de polisulfona (0.039±0.002 a 0.043±0.001 ng / 106 células, P<0,01), pero disminuyó con membranas de polinefrona (0.045±0.001 a 0.036±0.001 ng / 106 células, P<0,01)...
Bisphenol A (BPA), a component of some dialysis membranes, accumulates in Chronic Kidney Disease (CKD). Observational studies have linked BPA exposure to kidney and cardiovascular injury in humans, and animal studies have described a causative link. Normal kidneys rapidly excrete BPA, but insufficient excretion may sensitize patients with CKD to adverse the effects of BPA. Using a crossover design, we studied the effect of dialysis with BPA-containing polysulfone or BPA-free polynephron dialyzers on BPA levels in 69 prevalent patients on hemodialysis: 28 patients started on polysulfone dialyzers and were switched to polynephron dialyzers; 41 patients started on polynephron dialyzers and were switched to polysulfone dialyzers. Results weregrouped for analysis. Mean BPA levels increased after one hemodialysis session with polysulfone dialyzers but not with polynephron dialyzers. Chronic (3-month) use of polysulfone dialyzers increase predialysis serum BPA levels, but do not reach statistical significance increase (from 48.8±6.8 to 69.1±10.1 ng/ml). Chronic use of polynephron dialyzers reduced predialysis serum BPA (from 70.6±8.4 to 47.1±7.5 ng/ml, P<0.05). Intracellular BPA in PBMCs increased after chronic hemodialysis with polysulfone dialyzers (from 0.039±0.002 to 0.043±0.001 ng/106 cells, P<0.01), but decreased with polynephron dialyzers (from 0.045±0.001 to 0.036±0.001 ng/106 cells, P<0.01). Furthermore, chronic hemodialysis with polysulfone dialyzers increased oxidative stress and inflammatory marker concentrations in circulation...
Bisphenol A (BPA), a component of some dialysis membranes, accumulates in Chronic Kidney Disease (CKD). Observational studies have linked BPA exposure to kidney and cardiovascular injury in humans, and animal studies have described a causative link. Normal kidneys rapidly excrete BPA, but insufficient excretion may sensitize patients with CKD to adverse the effects of BPA. Using a crossover design, we studied the effect of dialysis with BPA-containing polysulfone or BPA-free polynephron dialyzers on BPA levels in 69 prevalent patients on hemodialysis: 28 patients started on polysulfone dialyzers and were switched to polynephron dialyzers; 41 patients started on polynephron dialyzers and were switched to polysulfone dialyzers. Results weregrouped for analysis. Mean BPA levels increased after one hemodialysis session with polysulfone dialyzers but not with polynephron dialyzers. Chronic (3-month) use of polysulfone dialyzers increase predialysis serum BPA levels, but do not reach statistical significance increase (from 48.8±6.8 to 69.1±10.1 ng/ml). Chronic use of polynephron dialyzers reduced predialysis serum BPA (from 70.6±8.4 to 47.1±7.5 ng/ml, P<0.05). Intracellular BPA in PBMCs increased after chronic hemodialysis with polysulfone dialyzers (from 0.039±0.002 to 0.043±0.001 ng/106 cells, P<0.01), but decreased with polynephron dialyzers (from 0.045±0.001 to 0.036±0.001 ng/106 cells, P<0.01). Furthermore, chronic hemodialysis with polysulfone dialyzers increased oxidative stress and inflammatory marker concentrations in circulation...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Farmacología, leída el 23-06-2016