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Concurrent Assessment of Micro- and Nanoplastics and Bisphenol A in Non-Dialysis Chronic Kidney Patients and Hemodialysis Patients: Results from a Cross-Sectional Human Biomonitoring Study Focusing on Sex-Related Patterns
Summary
People with kidney disease, especially those on dialysis, had noticeably higher levels of tiny plastic particles (microplastics and nanoplastics) in their blood compared to healthy people, likely because damaged kidneys can't filter them out as well and dialysis equipment may add more plastic exposure. Interestingly, women and men showed different patterns of plastic buildup depending on their kidney disease status, suggesting sex may play a role in how these particles accumulate in the body. This matters because it points to kidney patients as a group who may be especially vulnerable to plastic pollution's health effects, an area that needs more research and monito
Patients with chronic kidney disease (CKD), particularly those receiving hemodialysis (HD), may be more vulnerable to exposure to micro- and nanoplastics (MNPs) and bisphenol A (BPA) because of impaired renal clearance and frequent contact to plastic-based medical devices. This study aimed to assess and compare the levels of blood MNPs and urinary BPA in HD patients, non-dialysis CKD patients, and healthy subjects with a focus on sex-related differences and the potential role of hemodialysis as an additional source of exposure. A cross-sectional human biomonitoring study was conducted. Blood and urine samples were collected to quantify BPA using gas chromatography–mass spectrometry (GC–MS) and MNPs using scanning electron microscopy coupled with an Energy-Dispersive X-ray Detector (SEM-EDX). Descriptive statistics included medians, interquartile ranges (IQRs), 95% confidence intervals, frequencies, and percentages. Blood MNP levels were higher in HD [9889 (4525–14,939) p/mL] and non-dialysis CKD patients [9234 (3354–15,429) p/mL] than in healthy subjects [5755 (2488–9042) p/mL]. Urinary MNP levels were also higher in non-dialysis CKD patients [1231 (0–8281) p/mL] than in healthy subjects [411 (0–1636) p/mL]. Urinary MNPs were smaller in non-dialysis CKD patients than in healthy subjects. In contrast, urinary BPA levels were lower in non-dialysis CKD patients [0.16 (0.12–0.16)] than in healthy subjects [0.98 (0.60–2.36)]. Sex-specific patterns were observed. Females had higher blood MNP levels than males among HD patients (median 9907 vs. 9063 p/mL) and healthy subjects (6627 vs. 4131 p/mL), whereas the opposite pattern was observed in non-dialysis CKD patients (10,083 vs. 7340 p/mL). Overall, these findings suggest an increased systemic burden of MNPs and altered BPA elimination in non-dialysis CKD and HD patients. The observed sex-specific patterns suggest that biological sex may contribute to differences in internal exposure within this vulnerable population.