Ávila Eduardo, Sepúlveda Rodrigo A, Retamal Jaime, Hachim Daniel
Department of Nephrology, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica, Santiago, Chile.
Department of Intensive Medicine, School of Medicine, Faculty of Medicine, Pontificia Universidad Católica, Santiago, Chile.
BMC Nephrol. 2025 Aug 22;26(1):482. doi: 10.1186/s12882-025-04401-y.
Hemodialysis, a cornerstone therapy for chronic kidney disease, represented a crucial advance in the evolution of artificial organs. While its success is largely due to its efficiency in removing uremic toxins, an equally important challenge is to uphold the primum non nocere principle by minimizing the harmful effects of membrane-blood interactions. This review examines the complex mechanisms and key interactions underlying membrane biocompatibility, including complement activation, inflammation, and coagulation disturbances, paving the way for their clinical implications. We also summarize recent innovations in membrane materials and surface engineering aimed at improving hemocompatibility and promoting safer hemodialysis treatments for improved clinical outcomes.
血液透析作为慢性肾脏病的基石性治疗方法，是人工器官发展历程中的一项重大进步。虽然其成功很大程度上归功于清除尿毒症毒素的效率，但一个同样重要的挑战是通过尽量减少膜 - 血液相互作用的有害影响来秉持“首要不伤害”原则。本综述探讨了膜生物相容性背后的复杂机制和关键相互作用，包括补体激活、炎症和凝血紊乱，为其临床应用奠定基础。我们还总结了膜材料和表面工程方面的最新创新，旨在提高血液相容性并促进更安全的血液透析治疗，以改善临床结局。
