Bisphenol A (BPA) is an endocrine-disrupting chemical, meaning it can interfere with the body’s hormonal system. Due to increasing health concerns, the European Union has introduced progressively stricter restrictions on BPA in food-contact materials. 

For dialysis patients, BPA exposure deserves particular attention because hemodialysis creates a direct and repeatedly occurring blood-contact pathway. BPA can leach from BPA-derived materials used in some dialyzers. Unlike BPA ingested with food, non-oral exposure can make BPA more directly systemically available, bypassing much of the first-pass metabolism that substantially reduces circulating unchanged BPA after oral exposure.

This is especially relevant because hemodialysis is performed repeatedly over many years, making exposure from medical devices potentially long-term and recurrent rather than occasional. BPA is metabolized mainly into conjugated forms that are normally eliminated through urine, while patients with end-stage kidney disease have severely impaired renal function. Elevated BPA concentrations have been reported in dialysis patients, and the European Commission's scientific committee specifically identified long-term exposure in dialysis patients as an area of concern.

What are the potential health effects of BPA?

BPA can interfere with hormone signaling and has been recognized in the EU for its endocrine-disrupting propertiesand reproductive toxicity concerns.

Scientific research has raised concerns about effects on the immune, reproductive, metabolic and nervous systems. BPA exposure is associated with inflammation, oxidative stress, metabolic changes and cardiovascular effects. These issues are particularly relevant to dialysis patients, who already have a high burden of cardiovascular disease and chronic inflammation.

The dialyzer itself can also influence BPA exposure. Clinical research has shown that serum BPA can increase following dialysis with certain BPA-containing polysulfone dialyzers, whereas the same increase was not observed with a BPA-free membrane. This demonstrates that the choice of dialyzer has a direct impact on a patient's BPA exposure.

The European Commission's scientific committee has previously concluded that a risk of adverse effects may exist when BPA becomes directly systemically available through non-oral exposure, specifically highlighting dialysis patients among the groups of concern. It recommended using medical devices that do not leach BPA where practicable, while also considering their clinical performance and the safety of alternative materials.

As hemodialysis is performed repeatedly over long periods, reducing unnecessary exposure to potentially harmful substances is an important consideration when suitable alternatives are available.

Therefore, we supply Nipro BPA-free dialyzers, giving dialysis centers an option to reduce BPA exposure while meeting their clinical and technical requirements.

Choosing a dialyzer should always be based on the patient's clinical needs and the product's approved specifications, but BPA-free alternatives can support a more precautionary approach to patient care.