Abstract: 【Abstract】Objective To evaluate the exposure of bisphenol A (BPA) and the influence of different dialysis membrane composition on BPA exposure in maintenance hemodialysis (MHD) patients. Methods A total of 66 chronic kidney disease patients with MHD were recruited and randomly divided into group A or group B. Group A was treated with polysulfone (PS) membrane dialyzer, and group B was treated with polyethersulfone (PES) membrane dialyzer for hemodialysis for 3 months. The dialyzer types for the two groups were then exchanged and used for hemodialysis for another 3 months. Fifteen healthy people were selected as the control group. EnzymElinked immunosorbent assay was used to measure serum BPA before and after the first dialysis, 3 months and 6 months after the treatment as well as serum BPA in healthy people for comparison. Results Serum BPA of the two MHD patient groups was significantly higher than that of healthy people (t=9.378, P＜0.001; t=8.784, P＜0.001). In group A after the first hemodialysis, serum BPA was significantly higher than that before hemodialysis (t=2.794, P=0.009); while in group B after the first hemodialysis, serum level did not change significantly as compared with the level before hemodialysis (t=- 0.631, P=0.533). In
group A after hemodialysis using PS membrane dialyzer for 3 months, serum level did not change significantly as compared with that of the value (t=1.721, P=0.095); after switching to hemodialysis using PES membrane dialyzer for 3 months, serum level decreased significantly as compared with that of the value and the value at the third month of the treatment (t=-4.690, P＜0.001; t=-6.378, P＜0.001). In group B after hemodialysis using PES membrane dialyzer for 3 months, serum level decreased significantly as compared with that of the value (t=-3.604, P=0.001); after switching to hemodialysis using PS membrane dialyzer for 3months, serum level increased significantly as compared with that before 3 months (t=4.412, P＜0.001) and similar to that of the baseline level (t=-0.679, P=0.502). After the treatment for 3 months, serum BPA was statistically different between the two groups (t= 3.367, P=0.002). Correlation analysis showed that serum BPA was positively correlated with dialysis age (r=0.391, P=0.001), body mass index (r=0.355, P=0.003), diabetes (r=0.364, P=0.003), and hyperlipidemia (r=0.405, P=0.001), and negatively correlated with residual urine volume (r=-0.721, P<0.001). Conclusions MHD patients are at the high risk of BPA accumulation, potentially
causing damage to multiple systems and affecting long- term prognosis. Long-term application of PS membrane dialyzer for hemodialysis increases the accumulation of BPA, while the application of PES membrane dialyzer for hemodialysis decreases this risk.

Key words: Bisphenol A, Hemodialysis, Chronic kidney disease, Dialyzer, Polysulfone membrane, Polyethersulfone membrane