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JNCI Journal of the National Cancer Institute 1990 82(9):783-787; doi:10.1093/jnci/82.9.783
© 1990 by Oxford University Press
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Journal of the National Cancer Institute, Vol. 82, No. 9, 783-787, May 2, 1990
© 1990 Oxford University Press

N-Nitrosodimethylamine Blood Levels in Patients With Chronic Renal Failure: Modulation of Levels by Ethanol and Ascorbic Acid

S. R. Dunn*, M. L. Simenhoff, P. S. Lele, S. Goyal, J. W. Pensabene, W. Fiddler

Department of Medicine, Division of Nephrology, Jefferson Medical College, Thomas Jefferson University Philadelphia, PA
Department of Medicine, Division of Nephrology, Jefferson Medical College, Thomas Jefferson University Philadelphia, PA

*Correspondence to: Stephen R. Dunn, Department of Medicine, Division of Nephrology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.

We measured levels of N-nitrosodimethylamine (NDMA) in peripheral blood from 13 fasting male patients, 30–74 years old, who had chronic renal failure, and in five healthy control subjects (four males and one female) 31–50 years old. In the patients, we found significant (P <.01) levels of NDMA (mean ± SD; 201 ± 111 ng/kg of blood), which is known to be carcinogenic in animals. Five minutes after oral administration of ethanol (0:4g/kg of body weight), all patients exhibited a significant (P <.01) rise in blood NDMA levels (338± 125 ng/kg), suggesting continuous endogenous formation of NDMA that was unmasked by ethanol‘s ability to inhibit first-pass hepatic metabolism of NDMA. In five of six patients, pretreatment with oral ascorbic acid resulted in a blunting, but not statistically significant, effect on maximum blood NDMA levels after consumption of ethanol. Mean levels were 340 ± 100 ng/kg before treatment with ascorbic acid and 237 ± 127 ng/kg during treatment. Ethanol administration unmasks increased gastrointestinal formation of NDMA in patients with chronic renal failure. Further studies are required to confirm a possible link between endogenous NDMA formation and the increased incidence of cancer in these patients. [J Natl Cancer Inst 82: 783–787, 1990]


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