Advanced Functional Materials in Kidney Dialysis: Progress, Challenges, and Clinical Prospects

ABSTRACT Hemodialysis is a critical life‐sustaining therapy for patients with end‐stage renal disease (ESRD). However, its long‐term efficacy is fundamentally constrained by the performance of dialysis membranes. Conventional polymeric membranes, primarily optimized for removing small solutes, are inadequate for clearing middle‐molecular‐weight and protein‐bound uremic toxins (PBUTs), which drive chronic inflammation, cardiovascular dysfunction, and dialysis‐related amyloidosis. Moreover, the hydrophobic nature and limited hemocompatibility of existing membranes often trigger immune activation, thrombogenesis, and fouling, compromising both treatment safety and patient comfort. This review provides a critical and integrative assessment of hemodialysis membrane technologies, bridging mechanistic transport theory with recent progress in advanced functional materials. Polymeric, inorganic, biomimetic, and mixed‐matrix systems are systematically analyzed to elucidate how structure, surface chemistry, and nanostructure govern toxin selectivity, biostability, and blood compatibility. Emerging strategies, such as zwitterionic and heparin‐mimetic coatings, nanomaterial‐enabled hybrid architectures, and adsorption‐diffusion coupling, are evaluated in relation to clinical scalability and regulatory readiness. Particular emphasis is placed on AI‐assisted and data‐driven membrane design, sustainable fabrication, and translational engineering as converging directions shaping next‐generation dialysis materials. These perspectives collectively outline a roadmap toward safer, smarter, and more durable hemodialysis systems, advancing personalized and environmentally responsible renal replacement therapies.