Toxicity Assessment of Long-Term Exposure to Hemodialysis Devices

Hemodialysis is a life-sustaining therapy for end-stage kidney disease, yet the devices enabling it paradoxically expose patients to chemical toxicants. Through long-term use, compounds such as di(2-ethylhexyl) phthalate, Bisphenol A (BPA) and its substitute Bisphenol S, N-methyl-2-pyrrolidone, and ethylene oxide leach from dialysis tubing, dialyzers, and other sterilized equipment. These substances, which have documented endocrine-disrupting, carcinogenic, and other toxic properties, pose significant health concerns. This comprehensive review synthesizes current evidence on hemodialysisspecific exposure levels, the toxicological profiles of these compounds, and their associated health impacts. These findings highlight the unique vulnerability of this population, who endure a dual burden of environmental and iatrogenic exposure. Consequently, the critical need for research into mitigation strategies, including alternative dialysis modalities and BPA-free membranes, and the development of safer materials that preserve functionality while minimizing patient risk is underscored.   Cite this article as: Tarrass F, Benjelloun M. Toxicity assessment of long-term exposure to hemodialysis devices. Turk J Nephrol. Published online February 10, 2026. doi:10.5152/turkjnephrol.2026.251179.