Solute removal efficiency and biocompatibility of the high-performance membrane - from engineering points of view

Two major prerequisites of high-performance dialysis membranes are superior biocompatibility and high removal efficiency of pathogenic substances of large molecular size. In this article, we present a review, in the context of recent research results, of the solute removal efficiency and biocompatibility of the high-performance membrane. The former is discussed in terms of differences in separation properties arising from the constituent materials, the dialysis membrane structures, internal filtration-accelerated dialyzers, optimization of the dialysis fluid flow, and solute removal by adsorption, and the latter in terms of invasion of endotoxins present in dialysis fluid, antioxidant actions, and properties of the internal surface of dialysis membranes. We also discuss the main properties and problems of currently available high-performance dialysis membranes. While the solute removal efficiency of high-performance dialysis membranes is already mostly satisfactory and no further significant improvements are expected, except in relation to the fractioning properties (selectivity), there is much scope for improvement in the biocompatibility of dialysis membranes. It is important that ultrahigh-performance dialysis membranes of superior biocompatibility are developed based on the results of basic studies carried out from the engineering point of view, reports from the manufacturers, and clinical outcomes.