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Elective haemodialysis increases exhaled isoprene.
Philipp Lirk1, Florian Bodrogi, Hartmann Raifer
1Department of Anesthesiology and Critical Care Medicine, Leopold Franzens University of Innsbruck, Anichstrasse 35, A-6020 Innsbruck, Austria.
Summary
Breath isoprene levels significantly increase after hemodialysis (HD) in end-stage renal disease patients. This study confirms higher isoprene post-HD, suggesting respiratory factors, not oxidative stress, may influence exhalation.
Area of Science:
- Clinical Chemistry
- Pulmonary Medicine
- Nephrology
Background:
- Uremic odor is common in end-stage renal disease (ESRD) patients.
- Limited research exists on exhaled air composition in ESRD patients undergoing hemodialysis (HD).
- Previous studies reported increased exhaled isoprene levels post-HD.
Purpose of the Study:
- To confirm increased isoprene levels in exhaled air after HD in ESRD patients.
- To investigate the relationship between isoprene kinetics and dialysis membranes.
- To explore potential factors influencing isoprene exhalation during HD.
Main Methods:
- 50 ESRD patients undergoing HD were studied.
- Two types of dialysis membranes were used: haemophan (n=23) and polysulphone (n=27).
- Exhaled air samples were analyzed using proton transfer reaction-mass spectrometry (PTR-MS).
Main Results:
- Isoprene concentration significantly increased after HD (39.14 ppbv before vs. 63.54 ppbv after, P<0.001).
- The average quotient of isoprene values before and after dialysis was 1.84.
- No significant differences in isoprene kinetics were observed between dialysis membrane types.
- No correlations were found between isoprene quotients and blood pressure, calorie intake, lipid-lowering drugs, or serum lipid levels.
Conclusions:
- Isoprene concentration in exhaled air is higher after HD compared to before HD.
- Significant interindividual variability in isoprene kinetics was observed.
- Oxidative stress is unlikely to be the cause of the isoprene rise.
- Respiratory variables may influence isoprene exhalation, warranting further investigation via online monitoring.