Onset, Time Course, and Persistence of Increased Haemodialysis-Induced Breath Isoprene Emission

Abstract

Recent findings of increased isoprene emission in the exhaled breath of patients undergoing haemodialysis and experimental evidence of the potential toxic and cancerogenic effects of isoprene hydrocarbon led us to assess how long haemodialysis patients are exposed to how much isoprene after a single haemodialysis session. Patients with end-stage renal failure on regular 4-hour (from 08.00 to 12.00 h) maintenance haemodialysis three times weekly were monitored. The breath isoprene content was analyzed by gas chromatography. Intrapatient evaluations were performed by collecting samples before, during, and immediately after the haemodialysis session, during the following hours, and on the following nondialysis day. The breath isoprene content increased in all patients. Isoprene overproduction showing a biphasic pattern was first detected soon after the dialysis session ended. These data show that haemodialyzed patients seem to be consistently exposed to high endogenous isoprene concentrations. The mechanisms and implications of this endogenous isoprene overproduction need to be elucidated with regard to the mevalonic pathway and in the physiopathological setting of the uraemia-dialysis syndrome.

Blood and breath profiles of volatile organic compounds in patients with end-stage renal disease

“…This characteristic breath isoprene behavior in response to dialysis has already been reported by numerous investigators [18-29], however, this is the first time that it is confirmed by parallel blood measurements. The advanced explanations for this phenomenon include hemodynamic stress, fluctuations of respiratory variables, or activation of metabolic pathways leading to mevalonic acid synthesis [19,21-23], nevertheless, none of them seems to be adequate [18]. Isoprene has received a growing interest in the field of breath gas analysis due to the fact that it may serve as a sensitive, non-invasive indicator of several diseases in human organism [31].…”

Significance of Exhaled Breath Test in Clinical Diagnosis: A Special Focus on the Detection of Diabetes Mellitus

“…Increased concentration of isoprene has been reported in breath after smoking [109]. Several studies found elevated isoprene breath concentrations during and after hemodialysis [110]. Relatively higher concentrations of sulfur-containing compounds have been reported in liver transplant patients [111] and patients with liver disease [112].…”

Detection of Volatile Malodorous Compounds in Breath: Current Analytical Techniques and Implications in Human Disease

“…Davies et al reported that isoprene concentration is significantly higher for patients on hemodialysis than for normal controls [131]. Also, as measured by SIFT-MS, breath isoprene level was markedly elevated immediately after treatment, as confirmed by Trovarelli et al [135]. Capodicasa et al found that isoprene levels were increased in exhaled air during hemodialysis, although they did not find any change in the exhaled concentrations of alkanes [136].…”