Surface zwitterionization of hemodialysismembranesfor hemocompatibility enhancement and protein-mediated anti-adhesion: A critical review

Abstract

Extracorporeal membranes have changed significantly over the recent decades since hemodialysis (HD) has extensively been used as a treatment for acute renal failure (ARF) and end-stage renal disease (ESRD).However, platelet consumption, complement cascade activation, plasma protein attachment, and thrombosis are some of the side effects that occur when blood is exposed to incompatible hemodialysis membranes reducing the efficacy of the therapy. Current clinical devices need the use of medicines such as anticoagulants, but then again, there is still a high risk of clotting and other problems.Therefore,developing new bio-inert biomaterials that are usually hydrophilic and electrically neutral is crucial for the creation of blood-compatible membranes and improving hemodialysis effectiveness. Zwitterionic materials which are well-known for their exceptional antifouling capabilitiesand their stable protein-resistance properties have recently been used to improve antifouling surfaces in hemocompatible membranes. Bio-basedpolymer membranes offer the possibility of lowering production costs, increasing biocompatibility, and antifouling properties, and reducing waste disposal difficulties.Our critical study provides a brief overview of recent advances in the synthesis, functionalization, and polymerization of zwitterionic monomers on membrane surfaces, as well as their in vitro and in vivo performances on the hemocompatibility and anti-biofouling properties of HD membranes.

Keywords

• Antifouling property
• Polymerization
• Hemodialysis membrane
• Hemocompatibility, Zwitterionic materials