Adsorption-based strategies for removing uremic toxins from blood

Chronic kidney disease leads to the accumulation of uremic toxins within the blood compartment. Engineered surface that adsorbs toxins from the blood compartment is a promising approach for clearing uremic toxins not easily removed using membrane-based dialysis techniques. A variety of adsorbent materials have been studied with the purpose of targeting a general group of toxins or a specific uremic toxin. Some of these structures have also been incorporated into toxin clearance systems, including column adsorption and membrane adsorption. This review focuses upon, as much as possible, adsorption studies that included the evaluation of uremic toxin removal. We also discuss certain special adsorbent systems like molecularly imprinted polymer and mixed matrix membranes. The clinical application of several adsorbent systems in uremic toxin removal is also reviewed. • Studies using activated carbon, zeolite, mesoporous silica and polymer for uremic toxin removal were reviewed. • The development of molecularly imprinted polymer (MIP) systems and mixed matrix membrane (MMM) in uremic toxin removal was reviewed. • Performance and efficacy of adsorbent systems used in vivo were reviewed and discussed.