N-NITROSODIMETHYLAMINE BLOOD-LEVELS IN PATIENTS WITH CHRONIC-RENAL-FAILURE - MODULATION OF LEVELS BY ETHANOL AND ASCORBIC-ACID

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] © 1990 Oxford University Press.