血液透析膜在血液相容性和毒素强化清除方面的研究进展

A State of Art of Hemodialysis Membranes in Hemocompatibility and Enhanced Removal of Toxins

慢性肾脏疾病患者体内内源性、外源性毒素的积累会加重肾脏负担甚至导致尿毒症,这些致病毒素被称为尿毒症毒素。血液透析是一种常见的终末期肾病治疗手段,可以清除血液中游离的小分子尿毒症毒素,但对中分子毒素和蛋白质结合化合物毒素的清除能力有限。血液透析膜材料的血液不相容往往会对患者健康造成影响,严重的会造成患者的病变甚至死亡。因此,改善血液透析膜的血液相容性和尿毒症毒素的强化清除成为了该领域的研究热点。传统改性方法中,通过膜表面亲水改性和表面带负电可以改善其血液相容性,在扩散基础上引入对流或吸附机制可以强化尿毒症毒素的清除。除传统改性方法外,一些新型血液透析膜也被开发用于改善血液透析膜的血液相容性以及尿毒症毒素的强化清除,如蛋白质仿生膜、纳米通道定向传输膜、三维模板多层纤维膜、抗凝生物膜以及自抗凝膜。介绍了血液透析膜在血液相容性和毒素强化清除方面的研究进展,为血液透析膜改性工作提供参考。

Accumulation of endogenous and exogenous toxins in patients with chronic kidney disease will increase the burden on the kidneys and even lead to uremia.These substances are called uremic toxins.Hemodialysis is a common treatment for end-stage renal disease.This treatment can remove free small molecule uremic toxins in the blood,but it is limited to remove middle molecular toxins and protein-binding compound toxins.Moreover,the blood incompatibility of hemodialysis membrane materials often affects the health of patients,and even cause disease or even death.Therefore,improving the hemocompatibility of hemodialysis membranes and strengthening their elimination performance have become hotspots in this field.In traditional modification methods,the hemocompatibility of hemodialysis membranes can be improved by hydrophilic modification and negative charge on the membrane surface,and the removal of uremia toxin can be enhanced by adding convection or adsorption mechanism on the basis of diffusion.Moreover,several novel hemodialysis membranes have also been developed to improve the biocompatibility and enhance removal of uremic toxins,such as protein bionic membranes,nanochannel directional transport membranes,3D template multilayer fiber membranes,anticoagulant membranes and self-anticoagulation membranes.This article introduces the research progress of hemodialysis membranes in terms of hemocompatibility and enhanced removal of toxins,which provides references for the modification of hemodialysis membranes.