Influence of dialysis membrane composition on plasma bisphenol A levels during online hemodiafiltration

PLoS One. 2018 Mar 12;13(3):e0193288. doi: 10.1371/journal.pone.0193288. eCollection 2018.


Introduction: Bisphenol A (BPA) is an ubiquitous environmental toxin that is also found in dialyzers. Online hemodiafiltration (OL-HDF) more efficiently clears high molecular weight molecules, and this may improve BPA clearance. However, the BPA contents of dialysis membranes may be a source of BPA loading during OL-HDF.

Methods: A prospective study assessed plasma BPA levels in OL-HDF patients using BPA-free (polynephron) or BPA-containing (polysulfone) dialyzers in a crossover design with two arms, after a run-in OL-HDF period of at least 6 months with the same membrane: 31 patients on polynephron at baseline were switched to polysulfone membranes for 3 months (polynephron-to-polysulfone) and 29 patients on polysulfone were switched to polynephron for 3 months (polysulfone-to-polynephron).

Results: After a run-in OL-HDF period of at least 6 months with the same membrane, baseline pre-dialysis BPA was lower in patients on polynephron (8.79±7.97 ng/ml) than in those on polysulfone (23.42±20.38 ng/mL, p<0.01), but still higher than in healthy controls (<2 ng/mL). After 3 months of polynephron-to-polysulfone switch, BPA was unchanged (8.98±7.88 to 11.14±15.98 ng/mL, ns) while it decreased on the polysulfone-to-polynephron group (23.42±20.38 to 11.41±12.38 ng/mL, p<0.01).

Conclusion: OL-HDF for 3 months with BPA-free dialyzer membranes was associated to a significant decrease in predialysis BPA levels when compared to baseline BPA levels while on a BPA-containing membrane.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Benzhydryl Compounds / blood*
  • Cross-Over Studies
  • Female
  • Hemodiafiltration / instrumentation*
  • Humans
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / therapy*
  • Male
  • Membranes, Artificial
  • Phenols / blood*
  • Polymers / adverse effects
  • Polymers / chemistry*
  • Prospective Studies
  • Renal Dialysis / instrumentation
  • Sulfones / adverse effects
  • Sulfones / chemistry*


  • Benzhydryl Compounds
  • Membranes, Artificial
  • Phenols
  • Polymers
  • Sulfones
  • polysulfone P 1700
  • bisphenol A

Grant support

The Renal, Vascular and Diabetes Laboratory is funded by Ministerio de Economia, Industria y competitividad: FIS ISCIII FEDER funds PI16/01298, PI15/00298, PI16/02057, PI16/01900, ISCIII-RETIC REDinREN RD12/0021 RD16/0009, CYTED IBERERC and Sociedad Madrileña de Nefrologia, Programa Intensificación Actividad Investigadora (ISCIII) to AO. This work was supported by a grant from Nipro corporation, and Fundación Renal Íñigo Álvarez de Toledo (FRIAT). The funders had no role in the design of the study, interpretation of the results, or the writing of the manuscript.