THOMAS P. GIBSON, M.D.; WILLIAM A. BRIGGS, M.D., F.A.C.P.; BETTY BOONE, PH.D.
To the editor: In the editorial note by Friedman and Rosen (1) concerning the accelerated degenerative cardiovascular disease associated with long-term maintenance hemodialysis, the authors state that "intensive efforts are required to delineate all reasons" for this complication. We would like to introduce for consideration a factor common to every patient on hemodialysis, the extracorporeal circuit.
The use of plastic tubing in hemodialysis as presently performed is indispensable. Di-2-ethylhexyl phthalate (DEHP) is the plasticizer most commonly used in the manufacture of hemodialysis tubing. Movement of DEHP into stored blood from polyvinyl chloride plastic bags and the delivery of DEHP to
GIBSON TP, BRIGGS WA, BOONE B. Cardiovascular Disease and Dialysis. Ann Intern Med. ;82:283. doi: 10.7326/0003-4819-82-2-283_1
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Published: Ann Intern Med. 1975;82(2):283.
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