| Summary: | Hemodialysis is the prevailing approach in renal replacement therapy, critically required for eliminating uremic toxins from the blood of individuals suffering from end-stage renal disease (ESRD), but its efficacy is hindered by membrane biocompatibility and inadequate removal of uremic toxins. Blood-membrane interactions during HD trigger immune responses, impacting thrombogenesis, complement activation, leukocyte activation, coagulation, cytokine production, and oxygen radical generation. Despite research progress, membrane biocompatibility remains a global concern due to potential harm, morbidity, and mortality. This article reviews dialysis fundamentals, encompassing historical context, the evolution of configurations and materials, commercially available membranes, challenges, and recent advancements in HD membranes furthermore this review highlights the impacting clinical studies conducted for hemodailysis advancement. It emphasizes the critical need for improved hemocompatibility, discussing recent research and techniques like surface modifications and coating. These approaches aim to minimize platelet activation, coagulation, and enhance membrane performance, showcasing promising potential for future improvements in dialysis outcomes and patient comfort. © 2024 The Korean Society of Industrial and Engineering Chemistry
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