Next-Generation Electrospun Nanofibrous Membranes for Dialysis: Materials, Functionalization, and Preclinical...

Chronic kidney disease and end-stage renal failure continue to impose a significant global health burden, necessitating efficient and safe hemodialysis therapies. Conventional dialysis membranes, while widely used, suffer from limitations including insufficient clearance of middle- and protein-bound toxins, poor fouling resistance, and suboptimal hemocompatibility, which restrict long-term efficacy. Electrospinning has emerged as a versatile technology for fabricating nanofibrous dialysis membranes with tunable fiber morphology, porosity, and multilayer architectures, enabling enhanced solute selectivity, water permeability, and biocompatibility. This review critically examines materials employed in electrospun membranes, including synthetic, natural, and hybrid polymers, and explores strategies for surface functionalization such as anticoagulant immobilization, antifouling coatings, and smart responsive modifications. Key challenges addressed include mechanical stability, long-term performance under clinical conditions, sterilization effects, scalability, reproducibility, and regulatory compliance. Emerging trends, such as adsorptive mixed-mode filters, wearable and portable systems, and sustainable biobased platforms, highlight opportunities to improve patient outcomes and environmental sustainability. Finally, the review identifies knowledge gaps, emphasizes the trade-offs between performance and safety, and outlines future directions for translating electrospun membranes from laboratory innovation to clinically viable, next-generation hemodialysis devices. This work underscores the transformative potential of electrospinning to enhance dialysis efficacy while meeting stringent regulatory and clinical requirements.