Advances in Enhancing Hemocompatibility of Hemodialysis Hollow-Fiber Membranes

Abstract

Hemodialysis, the most common modality of renal replacement therapy, is critically required to remove uremic toxins from the blood of patients with end-stage kidney disease. However, the chronic inflammation, oxidative stress as well as thrombosis induced by the long-term contact of hemoincompatible hollow-fiber membranes (HFMs) contribute to the increase in cardiovascular diseases and mortality in this patient population. This review first retrospectively analyzes the current clinical and laboratory research progress in improving the hemocompatibility of HFMs. Details on different HFMs currently in clinical use and their design are described. Subsequently, we elaborate on the adverse interactions between blood and HFMs, involving protein adsorption, platelet adhesion and activation, and the activation of immune and coagulation systems, and the focus is on how to improve the hemocompatibility of HFMs in these aspects. Finally, challenges and future perspectives for improving the hemocompatibility of HFMs are also discussed to promote the development and clinical application of new hemocompatible HFMs.

Graphical Abstract

Keywords

Hemodialysis / Hollow fiber membranes / Hemocompatibility / Surface modification / Hemocompatibility characterization

References

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Funding

National Natural Science Foundation of China(51773127)

China Scholarship Council

Canadian Institutes of Health Research

Natural Sciences and Engineering Research Council (NSERC) of Canada

Foundation for Canadian Studies in the United Kingdom

Michael Smith Foundation for Health Research Scholar

RIGHTS & PERMISSIONS

Donghua University, Shanghai, China