Novel insights in hemodialysis: Most recent theories on membrane hemocompatibility improvement

Mollahosseini, Arash; Abdelrasoul, Amira

doi:10.1016/j.bea.2022.100034

Cited by 12 publications

(11 citation statements)

References 95 publications

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“…We highlighted the main reasons related to membrane chemistry and morphology. Our research group has conducted extensive studies on hemodialysis membrane modification to improve its compatibility [30][31][32][33][34][35][36][37][38][39][40][41]. However, it is crucial to correlate the key factors of membrane compatibility and its morphological structures with the aim of enhancing the quality of life of dialysis patients.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life of Dialysis Patients: Exploring the Influence of Membrane Hemocompatibility and Dialysis Practices on Psychosocial and Physical Symptoms

Doan,

Shoker,

Abdelrasoul

2024

J. Compos. Sci.

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Hemodialysis (HD) is a life-sustaining membrane-based therapy that is essential for managing kidney failure. However, it can have significant physical and psychological effects on patients due to chronic or acute consequences related to membrane bioincompatibility. End-stage renal disease (ESRD) patients on hemodialysis have a high incidence of psychiatric illness, particularly depression and anxiety disorders, and poor quality of life has been observed. Dialysis can also lead to physical symptoms of its own, such as fatigue, loss of appetite, anemia, low blood pressure, and fluid overload, in addition to the symptoms associated with kidney failure. Therefore, this critical review aims to comprehensively understand the impact of dialysis membrane bioincompatibility and the use of varying molecular weight cut-off membranes on the physical and psychological symptoms experienced by dialysis patients. We analyzed the latest research on the correlation between major inflammatory biomarkers released in patients’ blood due to membrane incompatibility, as well as the critical influence of low levels of hemoglobin and vital proteins such as human serum albumin due to the use of high-cut-off membranes and correlated these factors with the physical and psychological symptoms experienced by dialysis patients. Furthermore, our study aims to provide valuable insights into the impact of dialysis on critical symptoms, higher hospitalization rates, and the quality of life of First Nations, as well as child and youth dialysis patients, in addition to diabetic dialysis patients. Our goal is to identify potential interventions aiming to optimize the dialysis membrane and minimize its negative effects on patients, ultimately improving their well-being and long-term outcomes.

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Section: Introductionmentioning

confidence: 99%

Quality of Life of Dialysis Patients: Exploring the Influence of Membrane Hemocompatibility and Dialysis Practices on Psychosocial and Physical Symptoms

Doan,

Shoker,

Abdelrasoul

2024

J. Compos. Sci.

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“…Dialysis membranes are crucial for end-stage renal disease (ESRD) patients since the chance of a kidney transplant is significantly low [ 1 , 2 , 3 ]. Polyethersulfone (PES) and polysulfone (PSF) are the most common membranes used in clinical applications and represent 93% of the market [ 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…PES has a higher clearance efficiency compared to PSF [ 7 ]. Nevertheless, PES membranes still contain shortcomings, including limited hemocompatibility [ 1 , 8 , 9 ], which triggers blood activation cascades, as the rate of morbidity and mortality in ESRD patients is still unacceptably high [ 3 , 10 , 11 , 12 ]. Reactions between blood proteins and the incompatible PES structures trigger the functional sites of the proteins.…”

Section: Introductionmentioning

confidence: 99%

“…Different approaches for PES membrane modifications have been investigated, ranging from non-destructive physical approaches to chemical alteration of the membrane [ 1 , 3 , 8 , 9 , 13 , 14 , 15 , 16 ]. Carboxybetaine (CB), sulfobetaine (SB), and phosphobetaine (PB) are the three common zwitterionic structures applied to membrane materials for hemocompatibility improvement.…”

Section: Introductionmentioning

confidence: 99%

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Aminolysis-Based Zwitterionic Immobilization on Polyethersulfone Membranes for Enhanced Hemocompatibility: Experimental, Computational, and Ex Vivo Investigations

Mollahosseini,

Bahig,

Shoker

et al. 2024

Biomimetics

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Dialysis membranes are not hemocompatible with human blood, as the patients are suffering from the blood–membrane interactions’ side effects. Zwitterionic structures have shown improved hemocompatibility; however, their complicated synthesis hinders their commercialization. The goal of the study is to achieve fast functionalization for carboxybetaine and sulfobetaine zwitterionic immobilization on PES membranes while comparing the stability and the targeted hemocompatibility. The chemical modification approach is based on an aminolysis reaction. Characterization, computational simulations, and clinical analysis were conducted to study the modified membranes. Atomic force microscopy (AFM) patterns showed a lower mean roughness for carboxybetaine-modified (6.3 nm) and sulfobetaine-modified (7.7 nm) membranes compared to the neat membrane (52.61 nm). The pore size of the membranes was reduced from values above 50 nm for the neat PES to values between 2 and 50 nm for zwitterionized membranes, using Brunauer–Emmett–Teller (BET) analysis. More hydrophilic surfaces led to a growth equilibrium water content (EWC) of nearly 6% for carboxybetaine and 10% for sulfobetaine-modified membranes. Differential scanning calorimetry (DSC) measurements were 12% and 16% stable water for carboxybetaine- and sulfobetaine-modified membranes, respectively. Sulfobetaine membranes showed better compatibility with blood with respect to C5a, IL-1a, and IL-6 biomarkers. Aminolysis-based zwitterionization was found to be suitable for the improvement of hemodialysis membranes. The approach introduced in this paper could be used to modify the current dialysis membranes with minimal change in the production facilities.

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“…Despite being uncharged, the ZW molecule is able to strongly bind water molecules, thus creating electrostatically induced hydration that is believed to hinder protein adsorption on the membrane surface [ 19 , 23 , 24 , 25 , 26 , 27 , 28 ]. This approach has been successfully implemented for many polymer structures, including PVDF membranes, resulting in a significant improvement in their biocompatibility and antifouling properties [ 29 , 30 , 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

Investigation on Human Serum Protein Depositions Inside Polyvinylidene Fluoride-Based Dialysis Membrane Layers Using Synchrotron Radiation Micro-Computed Tomography (SR-μCT)

2023

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Hemodialysis (HD) membrane fouling with human serum proteins is a highly undesirable process that results in blood activations with further severe consequences for HD patients. Polyvinylidene fluoride (PVDF) membranes possess a great extent of protein adsorption due to hydrophobic interaction between the membrane surface and non-polar regions of proteins. In this study, a PVDF membrane was modified with a zwitterionic (ZW) polymeric structure based on a poly (maleic anhydride-alt-1-decene), 3-(dimethylamino)-1-propylamine derivative and 1,3-propanesultone. Fourier transform infrared spectroscopy (FTIR), scanning electron microscope (SEM), and zeta potential analyses were used to determine the membrane’s characteristics. Membrane fouling with human serum proteins (human serum albumin (HSA), fibrinogen (FB), and transferrin (TRF)) was investigated with synchrotron radiation micro-computed tomography (SR-μCT), which allowed us to trace the protein location layer by layer inside the membrane. Both membranes (PVDF and modified PVDF) were detected to possess the preferred FB adsorption due to the Vroman effect, resulting in an increase in FB content in the adsorbed protein compared to FB content in the protein mixture solution. Moreover, FB was shown to only replace HSA, and no significant role of TRF in the Vroman effect was detected; i.e., TRF content was nearly the same both in the adsorbed protein layer and in the protein mixture solution. Surface modification of the PVDF membrane resulted in increased FB adsorption from both the protein mixture and the FB single solution, which is supposed to be due to the presence of an uncompensated negative charge that is located at the COOH group in the ZW polymer.

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Novel insights in hemodialysis: Most recent theories on membrane hemocompatibility improvement

Cited by 12 publications

References 95 publications

Quality of Life of Dialysis Patients: Exploring the Influence of Membrane Hemocompatibility and Dialysis Practices on Psychosocial and Physical Symptoms

Quality of Life of Dialysis Patients: Exploring the Influence of Membrane Hemocompatibility and Dialysis Practices on Psychosocial and Physical Symptoms

Aminolysis-Based Zwitterionic Immobilization on Polyethersulfone Membranes for Enhanced Hemocompatibility: Experimental, Computational, and Ex Vivo Investigations

Investigation on Human Serum Protein Depositions Inside Polyvinylidene Fluoride-Based Dialysis Membrane Layers Using Synchrotron Radiation Micro-Computed Tomography (SR-μCT)

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