Latest advances in zwitterionic structures modified dialysis membranes

End-stage renal diseases are affecting many patients and as a result, demand to receive dialysis service is growing annually. Morbidity and mortality rates are reported to be higher in comparison with healthy humans. The reason is reported to be the hemoincompatiblity of blood purification membranes, which hinders patients’ lives. Activation of different immune systems in the body, in case of blood-membrane interaction, results in several side effects, of which cardiovascular shocks have been mentioned to be a major one. Efforts to solve this issue have resulted in different generations of dialysis membranes. Zwitterionic immobilized membranes are the latest (third) generation, which owns a higher degree of hemocompatiblity with more stability of immobilized structures. This critical review intends to cover recent efforts conducted over the zwitterionization of polymeric membrane surfaces with the goal of improving hemocompatibility. Different aspects of third-generation membranes are discussed for a better understanding of the current gap and gathering the knowledge to further develop the field. Accordingly, this critical survey provides an in-depth understanding of blood purification membranes zwitterionization for paving the way for the optimum enhancement of hemodialysis membrane hemocompatibility.     

Surface modification of SPEU films by ozone induced graft copolymerization to improve hemocompatibility

Surface modification of segmented poly(ether urethane) (SPEU) by graft copolymerization with N,N′-dimethyl-N-methacryloyloxyethyl-N-(3-sulfopropyl) ammonium (DMMSA), a zwitterionic sulfobetaine structure, was conducted. A simple two-step procedure for grafting of DMMSA onto the surface of SPEU film was used. The surface was first treated with ozone to introduce active hydroperoxide groups. The active surface was then exposed to the DMMSA solution in the sealed tube. Grafted SPEU film was characterized by ATR–FTIR, XPS and contact angle measurement. ATR–FTIR and XPS investigations confirmed the graft copolymerization. The monomer concentration, copolymerization temperature and time were varied to maximize the efficiency of DMMSA grafting. The equilibrium water content (EWC) and contact angle measurements showed that the hydrophilicity of the film had been greatly improved. The blood compatibility of the grafted films was evaluated by platelet adhesion in platelet rich plasma (PRP), deposits in blood control and protein adsorption in bovine fibrinogen using SPEU film as the control. No platelet adhesion and no thrombus were observed for the grafted films incubated in PRP for 300 min and in blood for 120 min, respectively. The protein adsorption was reduced on the grafted films after incubation in bovine fibrinogen for 120 min. These results proved that improved blood compatibility was obtained by grafting this new zwitterionic sulfobetaine structure monomer onto SPEU film.     

Synthesis and characterization of chitosan grafted poly(N,N-dimethyl-N-methacryloxyethyl-N-(3-sulfopropyl) ammonium) initiated by ceric (IV) ion

Grafting of N,N-dimethyl-N-methacryloxyethyl-N-(3-sulfopropyl) ammonium (DMMSA) onto chitosan using ceric ammonium nitrate as an initiator was studied under nitrogen atmosphere in 2% wt. acetic acid solution. The grafted polymer was confirmed by FT-IR spectroscopy. The extent of grafting could be adjusted by controlling the appropriate reaction conditions. The maximum percentage of grafting about 50% was obtained under optimum condition. A representative grafted copolymer was characterized by thermogravimetric analysis and chitosan was used as reference.