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Open Access Highly Accessed Research article

Blood and breath profiles of volatile organic compounds in patients with end-stage renal disease

Paweł Mochalski12, Julian King1, Matthias Haas1, Karl Unterkofler1, Anton Amann13* and Gert Mayer4*

Author Affiliations

1 Breath Research Institute, University of Innsbruck, Rathausplatz 4, A-6850 Dornbirn, Austria

2 Institute of Nuclear Physics PAN, Radzikowskiego 152, PL-31342 Kraków, Poland

3 Univ.-Clinic for Anesthesia, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria

4 Department of Internal Medicine IV-Nephrology and Hypertension, Innsbruck Medical University, Anichstrasse 35, A-6020 Innsbruck, Austria

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BMC Nephrology 2014, 15:43  doi:10.1186/1471-2369-15-43

Published: 8 March 2014

Abstract

Background

Monitoring of volatile organic compounds (VOCs) in exhaled breath shows great potential as a non-invasive method for assessing hemodialysis efficiency. In this work we aim at identifying and quantifying of a wide range of VOCs characterizing uremic breath and blood, with a particular focus on species responding to the dialysis treatment.

Methods

Gas chromatography with mass spectrometric detection coupled with solid-phase microextraction as pre-concentration method.

Results

A total of 60 VOCs were reliably identified and quantified in blood and breath of CKD patients. Excluding contaminants, six compounds (isoprene, dimethyl sulfide, methyl propyl sulfide, allyl methyl sulfide, thiophene and benzene) changed their blood and breath levels during the hemodialysis treatment.

Conclusions

Uremic breath and blood patterns were found to be notably affected by the contaminants from the extracorporeal circuits and hospital room air. Consequently, patient exposure to a wide spectrum of volatile species (hydrocarbons, aldehydes, ketones, aromatics, heterocyclic compounds) is expected during hemodialysis. Whereas highly volatile pollutants were relatively quickly removed from blood by exhalation, more soluble ones were retained and contributed to the uremic syndrome. At least two of the species observed (cyclohexanone and 2-propenal) are uremic toxins. Perhaps other volatile substances reported within this study may be toxic and have negative impact on human body functions. Further studies are required to investigate if VOCs responding to HD treatment could be used as markers for monitoring hemodialysis efficiency.

Keywords:
Blood analysis; End-stage renal disease; Breath analysis; Hemodialysis; Uremic syndrome; Volatile organic compounds