Tannic acid and Poly(N-acryloyl morpholine) layer-by-layer built hemodialysis membrane surface for intervening oxidative stress integrated with high biocompatibility and dialysis performance

Oxidative stress is a compelling risk factor during hemodialysis in patients with renal failure to elevated mortality risk. Intervening the effect of oxidative stress in the pathogenesis of dialysis-associated complications requires developing a more direct hemodialysis membrane route to prevent and relieve oxidative stress in the dialysis process. In this work, combining the anti-oxidative property of tannic acid (TA) and high biocompatibility of poly (N-acryloyl morpholine) (PACMO), the TA-PACMO functionalized poly (ether sulfone) (PES) hemodialysis membranes have been fabricated using the hydrogen-bonded layer-by-layer (HB-LbL) assembly technology. The functionalized membranes directly quenched excess reactive oxygen species, improved the serum total antioxidant capacity, and suppressed lipid peroxidation and protein glycosylation. More interestingly, the TA-PACMO functionalized hemodialysis membranes effectively protected cardiomyocytes (H9C2), and vascular endothelial cells (HUVEC) from oxidative damage the improvement of antioxidant enzymes activities such as superoxide dismutase and catalase. The introduction of PACMO indicated in considerable improvement of blood compatibility and reduction of complement activation compared to a single TA modified hemodialysis membrane. The typical toxins, including urea and lysozyme, were efficiently removed from the dialysis simulant experiment, confirming the feasibility of the TA-PACMO HB-LbL functionalized strategy. The results revealed that, with the TA-PACMO content increasing, the functionalized membranes with superior comprehensive performances had stronger anti-oxidative stress, better biocompatibility, and more efficient dialysis performance. The present work provided a promising candidate in the development and application of hemodialysis membrane against oxidative stress, which alleviated patients' complications to address the long-term hemodialysis.