7682420a3e0c754a8da2be58055ca139 jox-15-00167.pdf 8595efd04767b179d162c0cb833de7f88260b504 jox-15-00167.pdf 95908c87db5815aaa6a39255680668c41fcd974cf35e0b9d8a813d755a3db213 jox-15-00167.pdf Title: DNA Damage and Bisphenol Levels in Chronic Kidney Disease Patients Undergoing Hemodialysis Subject: Bisphenol (BP) compounds are widely present in the environment, primarily due to their use as plastic additives. These substances involve health risks, particularly as endocrine disruptors. While the general population is chronically exposed, patients with end-stage chronic kidney disease undergoing hemodialysis (HD-CKD) represent a particularly vulnerable group. This is due to both impaired renal clearance of circulating BPs and potential contamination from plastic-containing dialyzers used in extracorporeal blood circulation. In this longitudinal study, from the 35 HD-CKD patients initially selected, 25 changed their conventional dialyzers to BPA-free dialyzers for 6 months. Blood serum samples were collected, at baseline and after the intervention, to quantify levels of five BP analogues: Bisphenol A (BPA), Bisphenol AF (BPAF), Bisphenol F (BPF), Bisphenol B (BPB), and Bisphenol S (BPS). Genotoxicity was assessed using the comet assay and the micronucleus test on peripheral white blood cells. Among the analyzed BPs, only BPAF showed a statistically significant reduction when using BPA-free dialyzers. In terms of genotoxicity, a significant decrease was observed only in primary DNA damage (mainly DNA strand breaks), with no notable changes in chromosomal damage. This is the first study to detect multiple BP analogues in HD-CKD patients, beyond BPA, and to associate human exposure to BPs with DNA damage biomarkers. The observed reduction in DNA damage in parallel with decreased BPAF levels highlights the importance of monitoring and minimizing BP exposure of this high-risk population. Keywords: bisphenols; chronic kidney patients; hemodialysis; BPA-free dialyzers; genotoxicity; comet assay; micronucleus assay Author: Cesar Emilio Ruiz, Lourdes Vela, Martí Nadal, Neus González, Ricard Marcos, Alba Hernández, Susana Pastor and Elisabeth Coll Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25; modified using OpenPDF 1.4.2 CreationDate: Fri Oct 17 05:39:24 2025 CEST ModDate: Fri Oct 17 05:43:16 2025 CEST Custom Metadata: yes Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 16 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 566688 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- AIRHKL+VnURWPalladioL Type 1 Custom yes yes yes 125 0 WGXWPG+URWPalladioL-Bold Type 1 Custom yes yes yes 126 0 FOAQNY+URWPalladioL-Roma Type 1 Custom yes yes yes 127 0 BDNLDN+URWPalladioL-Ital Type 1 Custom yes yes yes 128 0 RSQVNE+CMSY10 Type 1 Builtin yes yes yes 215 0 CAMXTK+EURM10 Type 1 Builtin yes yes yes 216 0 RIESPW+URWPalladioL-BoldItal Type 1 Custom yes yes yes 217 0 JONGBP+PalatinoLinotype TrueType WinAnsi yes yes no 259 0 JONGAN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 260 0 JONGBP+PalatinoLinotype TrueType WinAnsi yes yes no 293 0 JONGAN+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 294 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-11-12 03:09:37 CET RepresentationInformation: jox-15-00167.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-11-11 14:34:36 CET Size: 566688 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 452 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: ViewerPreferences: HideToolbar: false HideMenubar: false HideWindowUI: false FitWindow: true CenterWindow: false DisplayDocTitle: false NonFullScreenPageMode: UseNone Direction: L2R ViewArea: CropBox ViewClip: CropBox PrintArea: CropBox PageClip: CropBox PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Item: Title: Materials and Methods Children: Item: Title: Study Population Item: Title: Study Design Item: Title: Determination of BP Levels in Blood Children: Item: Title: Instrumentation Item: Title: Sample Treatment Item: Title: Reagents and Chemicals Item: Title: Determination of Genomic and Chromosomal Damage Item: Title: Statistical Analysis Item: Title: Results and Discussion Children: Item: Title: Characteristics of the Study Population Item: Title: Bisphenol Levels in the Blood of HD-CKD Patients Included in the Study Item: Title: Genomic Damage in HD-CKD Patients Before and After Moving to Use BP-Free Dialyzers Item: Title: Factors Modulating the DNA Damage Decrease (Comet Assay) When Moving to BP-Free Dialyzers Item: Title: Conclusions Item: Title: References Info: Title: DNA Damage and Bisphenol Levels in Chronic Kidney Disease Patients Undergoing Hemodialysis Author: Cesar Emilio Ruiz, Lourdes Vela, Martí Nadal, Neus González, Ricard Marcos, Alba Hernández, Susana Pastor and Elisabeth Coll Subject: Bisphenol (BP) compounds are widely present in the environment, primarily due to their use as plastic additives. These substances involve health risks, particularly as endocrine disruptors. While the general population is chronically exposed, patients with end-stage chronic kidney disease undergoing hemodialysis (HD-CKD) represent a particularly vulnerable group. This is due to both impaired renal clearance of circulating BPs and potential contamination from plastic-containing dialyzers used in extracorporeal blood circulation. In this longitudinal study, from the 35 HD-CKD patients initially selected, 25 changed their conventional dialyzers to BPA-free dialyzers for 6 months. Blood serum samples were collected, at baseline and after the intervention, to quantify levels of five BP analogues: Bisphenol A (BPA), Bisphenol AF (BPAF), Bisphenol F (BPF), Bisphenol B (BPB), and Bisphenol S (BPS). Genotoxicity was assessed using the comet assay and the micronucleus test on peripheral white blood cells. Among the analyzed BPs, only BPAF showed a statistically significant reduction when using BPA-free dialyzers. In terms of genotoxicity, a significant decrease was observed only in primary DNA damage (mainly DNA strand breaks), with no notable changes in chromosomal damage. This is the first study to detect multiple BP analogues in HD-CKD patients, beyond BPA, and to associate human exposure to BPs with DNA damage biomarkers. The observed reduction in DNA damage in parallel with decreased BPAF levels highlights the importance of monitoring and minimizing BP exposure of this high-risk population. 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