Background: Monitoring of volatile organic compounds (VOCs) in exhaled breath shows great potential as a non-invasive\nmethod for assessing hemodialysis efficiency. In this work we aim at identifying and quantifying of a wide range of VOCs\ncharacterizing uremic breath and blood, with a particular focus on species responding to the dialysis treatment.\nMethods: Gas chromatography with mass spectrometric detection coupled with solid-phase microextraction as\npre-concentration method.\nResults: A total of 60 VOCs were reliably identified and quantified in blood and breath of CKD patients.\nExcluding contaminants, six compounds (isoprene, dimethyl sulfide, methyl propyl sulfide, allyl methyl sulfide,\nthiophene and benzene) changed their blood and breath levels during the hemodialysis treatment.\nConclusions: Uremic breath and blood patterns were found to be notably affected by the contaminants from\nthe extracorporeal circuits and hospital room air. Consequently, patient exposure to a wide spectrum of volatile\nspecies (hydrocarbons, aldehydes, ketones, aromatics, heterocyclic compounds) is expected during hemodialysis.\nWhereas highly volatile pollutants were relatively quickly removed from blood by exhalation, more soluble ones\nwere retained and contributed to the uremic syndrome. At least two of the species observed (cyclohexanone\nand 2-propenal) are uremic toxins. Perhaps other volatile substances reported within this study may be toxic\nand have negative impact on human body functions. Further studies are required to investigate if VOCs\nresponding to HD treatment could be used as markers for monitoring hemodialysis efficiency.
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