Impact of Hemodialysis on Exhaled Volatile Organic Compounds in End-Stage Renal Disease: A Pilot Study

Abstract

Aim: To demonstrate the feasibility of nanomaterial-based sensors for identifying patterns of exhaled volatile organic compound of end-stage renal disease (ESRD) and study the impact of hemodialysis (HD) on these patterns. Patients & methods: Exhaled breath samples were collected from a group of 37 volunteers (26 ESRD HD patients; 11 healthy controls); a third of the samples were randomly blinded for determining the sensitivity/specificity of the method. Discriminant function analysis was used to build a model for discriminating ESRD patients and healthy controls (classification accuracy for blind samples: 80%), based on the signals of the nanomaterial sensors. Results & conclusion: The breath pattern of the ESRD patients approached the healthy pattern during the HD treatment, without reaching it completely. Gas chromatography/mass spectrometry identified four volatile organic compounds as potential ESRD biomarkers. Although this pilot study has yielded encouraging results, additional large-scale clinical studies are required to develop a fast, noninvasive breath test for monitoring HD adequacy in real time.

Keywords::

• breath test
• carbon nanotube
• dialysis adequacy
• end-stage renal disease
• gold nanoparticle
• hemodialysis
• sensor
• volatile organic compound

Financial & competing interests disclosure

The research leading to these results has received funding from the Nofar Fund of the Israeli Ministry of Industry. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Acknowledgement

The authors would like to thank YY Broza (Department of Chemical Engineering, Technion, Haifa, Israel) for helpful discussions.

Additional information

Funding

The research leading to these results has received funding from the Nofar Fund of the Israeli Ministry of Industry. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.