Bisphenol S is a haemodialysis-associated xenobiotic that is less toxic than bisphenol A

Abstract

Background. Bisphenol S (BPS) is a structural analogue of bisphenol A (BPA) that is found in the environment. BPS may accumulate in anuric patients due to decreased urinary excretion. The toxicity and health effects of BPS are poorly characterized. Methods. A cross-over study was performed using polynephron (PN) or polysulphone (PS) dialysers for a short (1 week each, 14 patients) or long (3 months each, 20 patients) period on each dialyser. Plasma BPA, BPS and hippuric acid were assessed by SRM mass spectrometry (SRM-MS). The biological significance of the BPS concentrations found was explored in cultured kidney tubular cells. Results. In haemodiafiltration (HDF) patients, plasma BPS was 10-fold higher than in healthy subjects (0.53 6 0.52 versus 0.05 6 0.01 ng/mL; P¼ 0.0015), while BPA levels were 35-fold higher (13.23 6 14.65 versus 0.37 6 0.12 ng/mL; P¼ 0.007). Plasma hippuric acid decreased after an HDF session, while BPS and BPA did not. After 3 months of HDF with the same membranes, the BPS concentration was 1.01 6 0.87 ng/mL for PN users and 0.62 6 0.21 ng/mL for PS users (P non-statistically significant). In vitro, BPS and BPA leaked from dialysers containing them. In cultured tubular cells, no biological impact (cytotoxicity, inflammatory and oxidative stress gene expression) was observed for BPS up to 200 mM, while BPA was toxic at concentrations 100 mM. Conclusions. BPS may be released from dialysis membranes, and dialysis patients display high BPS concentrations. However, BPS concentrations are lower than BPA concentrations and no BPS toxicity was observed at concentrations found in patient plasma. Keywords: bisphenol A, bisphenol S, chronic kidney disease, haemodialysis, haemodiafiltration, toxins, xenobiotics