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提高血液透析中空纤维膜血液相容性的研究进展

Advances in Enhancing Hemocompatibility of Hemodialysis Hollow-Fiber Membranes.

作者信息

Ji Haifeng, Li Yupei, Su Baihai, Zhao Weifeng, Kizhakkedathu Jayachandran N, Zhao Changsheng

机构信息

College of Polymer Science and Engineering, State Key Laboratory of Polymer Materials Engineering, Sichuan University, Chengdu, 610065 People's Republic of China.

Department of Pathology and Lab Medicine & Center for Blood Research & Life Science Institute, 2350 Health Sciences Mall, Life Sciences Centre, The School of Biomedical Engineering, University of British Columbia, Vancouver, BC V6T 1Z3 Canada.

出版信息

Adv Fiber Mater. 2023 Apr 3:1-43. doi: 10.1007/s42765-023-00277-5.

DOI:10.1007/s42765-023-00277-5
PMID:37361105
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10068248/
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.

摘要

血液透析是肾脏替代治疗最常见的方式，对于从终末期肾病患者血液中清除尿毒症毒素至关重要。然而，血液不相容的中空纤维膜（HFMs）长期接触所引发的慢性炎症、氧化应激以及血栓形成，导致该患者群体心血管疾病的增加和死亡率上升。本综述首先回顾性分析了目前在改善HFMs血液相容性方面的临床和实验室研究进展。描述了目前临床使用的不同HFMs及其设计细节。随后，我们阐述了血液与HFMs之间的不良相互作用，包括蛋白质吸附、血小板黏附和活化以及免疫和凝血系统的激活，重点是如何在这些方面提高HFMs的血液相容性。最后，还讨论了改善HFMs血液相容性面临的挑战和未来前景，以促进新型血液相容性HFMs的开发和临床应用。

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