Modification of polyethersulfone membrane by blending semi-interpenetrating network polymeric nanoparticles

Manufacturing and Separation Characteristics of Hemodialysis Membranes to Improve Toxin Removal Rate

With the recently growing interest in health care, hemodialysis is being performed not only to treat patients with renal disease but also to improve blood circulation. At present, filters used for hemodialysis are manufactured only in certain countries, and all other countries must rely on imports. In this study, polyethersulfone (PES), which has excellent blood compatibility, was used as the main material to develop hemodialysis membranes for hemodialysis filters, and these hemodialysis membranes were prepared by adding a hydrophilic polymer, polyvinylpyrrolidone (PVP), and varying the type of nonsolvent during the manufacturing process to improve the toxin removal rate and biocompatibility. The addition of PVP was confirmed through attenuated total reflection Fourier transform infrared (ATR-FTIR), and the structure of the membranes depending on the nonsolvent was analyzed through scanning electron microscopy (SEM) and atomic force microscopy (AFM) images. The contact angle results indicated that the hydrophilicity of the membrane surface was improved as the concentration of PVP increased. The results of the toxin filtration efficiency experiment using urea, creatinine, and bovine serum albumin (BSA) confirmed removal rates of 58.8% and 56.87%, respectively, and a protein loss of less than 8%. Also, cell viability was over 90% at the PVP concentration of 2% or higher. A preliminary study was conducted on the improvement of toxin filtration efficiency and the development potential of these hemodialysis membranes with excellent biocompatibility.

One-Step Water-Induced Phase Separation Simultaneously Triggering Polymer Solidification and Polyelectrolyte Complexation for Porous Ultrafiltration Membranes

Functional additives have been widely utilized for the membrane structure modulation and performance improvement during the nonsolvent-induced phase separation process, but the resulted membranes easily suffer from additives' inhomogeneous dispersity and compatibility with the polymer matrix. Herein, a facile and robust strategy, i.e., one-step water-induced phase separation, was proposed for the preparation of polyelectrolytes-contained composite membranes. Polyanion (dopamine modified polyacrylic acid) and polycation (quaternized chitosan paired with bis(trifluoromethane-sulfonyl)imide) were first premixed in dimethyl sulfoxide and used as polyelectrolyte additives in a polysulfone (PSF) solution, and then a uniform PSF-based casting solution was readily obtained. During the solvent-water exchange process, polymer solidification and polyelectrolyte complexation were simultaneously triggered, in situ generating a polyelectrolyte complex fixed within the membrane matrix. Ultrafiltration membranes with hierarchical structures were notably tailored through altering the concentration, molecular weight, and type of polyelectrolytes. The obtained membrane exhibited a water flux of 672 L·m^-2·h^-1, three times over the raw PSF membrane, while almost maintaining high bovine serum albumin (BSA) rejection. This work paves a straightforward and convenient path for the preparation of composite membranes with tunable architecture and properties.

Preparation, characterization, and performance of PES/GO woven mixed matrix nanocomposite forward osmosis membrane for water desalination

Mixed matrix woven forward osmosis (MMWFO) membranes made of polyethersulfone (PES)/graphene oxide nanosheets (GO NSs) were made by inserting varying wt% ratios of GO NSs (zero to 0.1 wt%) into the PES matrix. A coated woven fabric material was used to cast the membrane polymer solution. The physical characteristics and chemical structures of the produced PES/GO MMWFO membranes were studied, including contact angle, hydrophilicity, porosity, tortuosity, function groups, chemical and crystallographic structures, nanomorphologies, and surface roughness. The performance of the prepared PES/GO FO membranes for water desalination was evaluated in terms of pure water flux (J_w), reverse salt flux (J_s), and salt rejection (SR). The hydrophilicity and porosity of the FO membrane improved with the addition of GO NSs, as did water permeability due to the development of multiple skin-layer structures with greater GO NS loading. These GO NSs establish shortcut pathways for water molecules to move through, reducing support layer tortuosity by three times, lowering support layer structural features, and minimizing internal concentration polarization (ICP). The PES/0.01 wt% GO MMWFO membrane with a total casting thickness of 215 μm and 1 M NaCl concentration had the best performance, with the highest J_w (114.7 LMH), lowest J_s (0.03 GMH), and lowest specific reverse solute flux (J_s/J_w = 0.00026 g L⁻¹), as well as a more favorable structural parameter (S = 149 μm). The performance of our optimized membrane is significantly better than that of the control woven commercial cellulose triacetate (CTA) FO membrane under optimal FO conditions. As the NaCl concentration increased from 0.6 to 2 M, J_w increased from 105 to 127 LMH which is much higher than the J_w of the commercial one (7.2 to 15 LMH). Our FO membranes have an SR of 99.2%@0.65 M NaCl, which is significantly greater than that of the CTA membrane.

Optimized FO membrane showed water flux 8.5 times that of commercial CTA membrane, salt rejection of 99.2%, and the lowest reported specific reverse solute flux (0.00026 g L⁻¹).

Lamotrigine loaded PLGA nanoparticles intended for direct nose to brain delivery in epilepsy: pharmacokinetic, pharmacodynamic and scintigraphy study

The present study aimed to investigate the brain targeting efficacy of Lamotrigine (LTG) loaded PLGA nanoparticles (LTG-PNPs) upon intranasal administration. LTG-PNPs were fabricated through the emulsification-solvent evaporation technique and evaluated for % Entrapment efficiency, particle size, in-vitro release, surface morphology, crystallinity, ex-vivo permeation & thermal behaviour. Biodistribution, gamma scintigraphy, and pharmacodynamic studies were performed in BALB/c mice, New Zealand rabbits, and Wistar rats respectively. LTG-PNPs exhibited % EE 71%; particle size 170.0 nm; Polydispersity index 0.191; zeta potential -16.60 mV. LTG-PNPs exhibited a biphasic release pattern. Biodistribution and gamma scintigraphy studies proved a greater amount of LTG in the brain following intranasal delivery of LTG-PNPs in comparison to LTG-SOL. Pharmacodynamic studies demonstrated delayed seizure onset time with LTG-PNPs in comparison to LTG-SOL. Intranasal administration of LTG-PNPs provided prolonged release, higher bioavailability, and better brain targeting bypassing the BBB. The developed formulation could be administered as a once-a-day formulation that would reduce the dosing frequency; dose; dose-related side effects; cost of the therapy and would be beneficial in the management of epilepsy as compared to the LTG-SOL. However, the proof of concept generated through these studies needs to be further validated in higher animals and human volunteers.

Halloysite Nanotube-Ferrihydrite Incorporated Polyethersulfone Mixed Matrix Membrane: Effect of Nanocomposite Loading on the Antifouling Performance

Membrane filtration is an attractive process in water and wastewater treatment, but largely restricted by membrane fouling. In this study, the membrane fouling issue is addressed by developing polyethersulfone (PES)-based mixed matrix membranes (MMMs) with the incorporation of hydrophilic nanoparticles as an additive. Ultrafiltration MMMs were successfully fabricated by incorporating different loadings of halloysite nanotube-ferrihydrates (HNT-HFO) into a polyethersulfone (PES) matrix and their performance was evaluated for the separation of bovine serum albumin (BSA) solution and oil/water emulsion. The results show that wettability is endowed to the membrane by introducing the additive aided by the presence of abundant -OH groups from the HFO. The loading of additive also leads to more heterogeneous surface morphology and higher pure water fluxes (516.33-640.82 L/m2h) more than twice that of the pristine membrane as reference (34.69 L/m2h) without affecting the rejection. The MMMs also provide much enhanced antifouling properties. The filtration results indicate that the flux recovery ratio of the modified membrane reached 100% by washing with only distilled water and a total flux recovery ratio of >98% ± 0.0471 for HNT-HFO-loaded membranes in comparison with 59% ± 0.0169 for pristine PES membrane.

Magnetic field assisted preparation of PES-Ni@MWCNTs membrane with enhanced permeability and antifouling performance

Multiple wall carbon nanotubes (MWCNTs), as an excellent material, have been used in various applications including preparation of polymer-MWCNTs composite membranes. However, few reports have combined the magnetic Ni@MWCNTs with polyether sulfone (PES) membrane to improve its antifouling performance to humic acid (HA), sodium alginate (SA), bovine serum albumin (BSA) and yeast (YE) solutions. In this study, the Ni@MWCNTs was generated by immersing MWCNTs into Ni²⁺ solution where in-situ reduction reaction was launched by the adsorbed Ag⁺ on MWCNTs. Since the loaded Ni endowed magnetism to MWCNTs, the Ni@MWCNTs can be easily attracted onto the membrane surface by an external magnetic field during the phase inversion process. The morphology measurements confirmed that the Ni@MWCNTs headed out of the PES-Ni@MWCNTs membrane surface. Because the MWCNTs played a role of free channels for water molecules, the composite membrane water flux reached to threefold flux of the pristine membrane. Moreover, the PES-Ni@MWCNTs membranes displayed the obviously enhanced antifouling ability during all the three alternative filtration cycles of water and BSA, SA, YE and HA solutions. In addition, the optimal PES-Ni@MWCNTs membrane demonstrated a flux recovery rate (FRR) of 67.89%, 85.53%, 60.28 and 90.12% for BSA, SA, YE and HA, respectively, which were not only much higher than that of the pristine membrane, but also exhibited significant improvements comparing with the previous studies. Further results of extended Derjaguin-Landau-Verwey-Overbeek (XDLVO) theory indicated that the modified membrane possessed advantageous interaction energies with contaminant molecules over the pristine membrane.

Production of High Flux Poly(Ether Sulfone) Membrane Using Silica Additive Extracted from Natural Resource

This paper reports the application of silica derived from natural biomasses of rice husk and bagasse ashes as membrane modifying agents. The modification was conducted on poly(ether sulfone) (PES) membrane by blending the silica into the dope solution. The modification was aimed to improve the structure and hydraulic performance of the resulting PES membrane. The effects of silica addition to the membrane system were evaluated through the analysis of change in chemical structure using ATR-FTIR, surface morphological change using AFM, and surface hydrophilicity using water contact angle measurement. SEM and AFM images show the silica loading significantly affects the membranes morphologies. Silica loading also promotes hydrophilic property as shown by the decrease in water contact angles from 82° to 52-60° due to the presence of polar groups in some residual silica in the membrane matrix. Silica blending also leads to the formation of membranes with higher permeability of up to three folds but lower humic acid rejection (78-62%). The findings indicate the role of silica to enhance the membrane pore size. The ability of membrane to reject humic acid (of 0.8 nm minimum diameter) indicating that the resulting membranes were in between tight ultrafiltration and nanofiltration type. Nonetheless, applying too-high silica concentration decreased the humic acid rejection most likely due to over enlargement of the membrane pore size.

Membrane bioreactors troubleshooting through the preparation of a high antifouling PVDF ultrafiltration mixed-matrix membrane blended with O-carboxymethyl chitosan-Fe3O4 nanoparticles

Polymeric ultrafiltration (UF) membranes often used in membrane bioreactor (MBR) prone to be fouled by fouling agents. Therefore, in this paper, the antifouling characteristics of polyvinylidene fluoride (PVDF) UF membranes for wastewater treatment are improved through modifying membranes by O-carboxymethyl chitosan (OCMCS)-functionalized Fe₃O₄ nanoparticles (OCMCSFe₃O₄). The modifier agent was manufactured by the adsorption of OCMCS on Fe₃O₄ nanoparticles, which were synthesized via co-precipitating method. Antifouling performance of membranes was assessed by permeation tests done using activated sludge suspension as a biological foulant, then the calculation of the pure water flux recovery ratio (FRR) and fouling resistance parameters. Also, to investigate the protein rejection of membranes, permeation tests were conducted by the bovine serum albumin (BSA) solution. According to the obtained results, surface hydrophilicity of the embedded membranes was improved in the low concentrations of the modified nanoparticles. However, the high quantity of the OCMCS-Fe₃O₄ nanoparticles (>0.1 wt. %) in the casting solution lessened membrane performance owing to the agglomeration of the nanoparticles in the polymer matrix. Although, the 1 wt. % OCMCS-Fe₃O₄ membrane revealed considerably higher PWF and permeation than that of the other membranes. It was because of defects and cracks in the membranes. The 0.05 wt. % OCMCS-Fe₃O₄/PVDF membrane exhibited the highest FRR (95.7%) and protein rejection value (48%) and the lowest irreversible fouling resistance (Rir) value (4.2%). It is concluded that the blended membranes with modified nanoparticles resulted in a high-flux ultrafiltration membrane comparable with microfiltration membrane, while its separation properties remained similar to UF membrane.

Hemodialysis performance and anticoagulant activities of PVP-k25 and carboxylic-multiwall nanotube composite blended Polyethersulfone membrane

Non-covalent electrostatic interaction between amide nitrogen and carbonyl carbon of shorter chain length of polyvinylpyrrolidone (PVP-k25) was developed with in-house carboxylic oxidized multiwall carbon nanotubes (O-MWCNT) and then blended with Polyethersulfone (PES) polymer. FTIR analysis was utilized to confirm bonding nature of nano-composites (NCs) of O-MWCNT/PVP-k25 and casting membranes. Non-solvent induces phase separation process developed regular finger-like channels in composite membranes whereas pristine PES exhibited spongy entities as studied by cross sectional analysis report of FESEM. Further, FESEM instrument was also utilized to observe the dispersion of O-MWCNT/PVP based nanocomposite (NCs) with PES and membranes leaching phenomena analysis. Contact angle experiments described 24% improvement of hydrophilic behaviour, leaching ratio of additives was reduced to 1.89%, whereas water flux enhanced up to 6 times. Bovine serum albumin (BSA) and lysozyme based antifouling analysis shown up to 25% improvement, whereas 84% of water flux was regained after protein fouling than pristine PES. Anticoagulant activity was reported by estimating prothrombin, thrombin, plasma re-calcification times and production of fibrinogen cluster with platelets-adhesions photographs and hemolysis experiments. Composite membranes exhibited 3.4 and 3 times better dialysis clearance ratios of urea and creatinine solutes as compared to the raw PES membrane.

Investigations on the Properties and Performance of Mixed-Matrix Polyethersulfone Membranes Modified with Halloysite Nanotubes

Ultrafiltration (UF) polyethersulfone (PES) membranes were prepared by wet phase inversion method. Commercial halloysite nanotubes (HNTs) in the amount of 0.5–4 wt % vs PES (15 wt %) were introduced into the casting solution containing the polymer and N,N-dimethylformamide as a solvent. The morphology, physicochemical properties and performance of the membranes were characterized by scanning electron microscopy (SEM) and atomic force microscopy (AFM), zeta potential, porosity and contact angle analyses, as well as permeability measurements. Moreover, the antifouling properties of the membranes were evaluated during UF of a model solution of bovine serum albumin (BSA). The research revealed a positive influence of modification with HNTs on hydrophilicity, water permeability and antifouling properties of the PES membranes. The most significant improvement of permeability was obtained in case of the membrane containing 2 wt % of HNTs, whereas the highest fouling resistance was observed for 0.5 wt % HNTs content. It was found that a good dispersion of HNTs can be obtained only at loadings below 2 wt %. Based on the results a relation between severity of membrane fouling and surface roughness was proved. Moreover, an increase of the roughness of the modified membranes was found to be accompanied by an increase of isoelectric point values.

Physical Processes in Polymeric Filters Used for Dialysis

The key physical processes in polymeric filters used for the blood purification include transport across the capillary wall and the interaction of blood cells with the polymer membrane surface. Theoretical modeling of membrane transport is an important tool which provides researchers with a quantification of the complex phenomena involved in dialysis. In the paper, we present a dense review of the most successful theoretical approaches to the description of transport across the polymeric membrane wall as well as the cell⁻polymer surface interaction, and refer to the corresponding experimental methods while studying these phenomena in dialyzing filters.

Multifunctionalized polyethersulfone membranes with networked submicrogels to improve antifouling property, antibacterial adhesion and blood compatibility

Intensive efforts have been employed in modifying biomedical membranes. Among them, blending is recognized as a simple method. However, the conventional blending materials commonly lead to an insufficient modification, which is mainly caused by the poor miscibility between the blending materials and the matrixes, the elution of the hydrophilic materials from the matrixes during the use and storage, and the insufficient surface enrichment of the blending materials. Aiming to solve the abovementioned disadvantages, we developed novel polyethersulfone/poly(acrylic acid-co-N-vinyl-2-pyrrolidone) networked submicrogels (PES/P(AA-VP) NSs), which were blended with PES to enhance the antifouling properties, antibacterial adhesion and haemocompatible properties of PES membranes. As results, the PES/P(AA-VP) NSs showed good miscibility with the PES matrix, and hydrophilic submicrogels would enrich onto the membrane surface during the phase inversion process due to the surface segregation. The entanglement between the PES matrix and the networked submicrogels would effectively limit the elution of the submicrogels. In conclusion, the modified PES membranes prepared by blending with the PES/P(AA-VP) NSs might draw great attention for the application in haemodialysis fields.

Polymer Nanocomposite Membranes

Based on the results of research works reflected in the scientific literature, the main examples, methods and approaches to the development of polymer inorganic nanocomposite materials for target membranes are considered. The focus is on membranes for critical technologies with improved mechanical, thermal properties that have the necessary capabilities to solve the problems of a selective pervaporation. For the purpose of directional changes in the parameters of membranes, effects on their properties of the type, amount and conditions of nanoparticle incorporation into the polymer matrix were analyzed. An influence of nanoparticles on the structural and morphological characteristics of the nanocomposite film is considered, as well as possibilities of forming transport channels for separated liquids are analyzed. Particular attention is paid to a correlation of nanocomposite structure-transport properties of membranes, whose separation characteristics are usually considered within the framework of the diffusion-sorption mechanism.

Highly permeable PVDF membrane with PS/ZnO nanocomposite incorporated for distillation process

In order to enhance the flux and wetting resistance of PVDF membranes for MD applications, we have developed a novel PVDF blend nanocomposite membrane using a polystyrene/ZnO (PS/ZnO) hybrid nanocomposite. The PS/ZnO nanocomposite was synthesized by free radical polymerization of styrene in the presence of vinyltrimethoxysilane (VTMS) grafted on the surface of ZnO nanoparticles. The blend nanocomposite membrane is fabricated via the phase inversion method and we examined the effects of the PS/ZnO nanocomposite on porosity, mechanical properties, hydrophobicity, LEPw, morphology, surface roughness and MD performance. It was found that the addition of the PS/ZnO hybrid nanocomposite (0.25, 0.5 and 0.75%) resulted in an increase in porosity (>70%), which is attributed to increased pore size and reduction of the spongy layer thickness. Furthermore, the addition of the nanocomposite also improved the surface roughness and contact angle. Comparison between the neat and modified membrane shows that with incorporation of the PS/ZnO nanocomposite, the desalination flux of 30 g L⁻¹ saline aqueous solution significantly increased and rejection reached 99.99%. Meanwhile, during 100 hours continuous desalination process, the membranes composed of 0.75% PS/ZnO hybrid nanocomposite exhibited high performance stability (15.79 kg m⁻² h⁻¹) compared with the neat PVDF membrane.

In order to enhance the flux and wetting resistance of PVDF membranes for MD applications, we have developed a novel PVDF blend nanocomposite membrane using a polystyrene/ZnO (PS/ZnO) hybrid nanocomposite.

Design of Antibacterial Poly(ether sulfone) Membranes via Covalently Attaching Hydrogel Thin Layers Loaded with Ag Nanoparticles

To inhibit bacteria attachment and the subsequent formation of biofilms on poly(ether sulfone) (PES) membranes, poly(sulfobetaine methacrylate)/poly(sodium acrylate) antibacterial hydrogel thin layers were covalently attached onto the membranes, followed by loading with Ag nanoparticles. In our strategy, double bonds were firstly introduced onto the PES membrane surfaces to provide anchoring sites, and then the hydrogel layers were synthesized on the membrane surfaces via UV light-initiated crosslinking copolymerization. Then, Ag ions were adsorbed into the hydrogel layers and reduced to Ag nanoparticles by sodium borohydride. The amounts of the adsorbed Ag ions were controlled by the mole ratios of carboxylate groups in the hydrogel layers. After attaching the hydrogel layers, a typical 3D porous structure was observed by scanning electron microscopy, and the surface chemical composition variations were characterized by attenuated total reflection-Fourier transform infrared spectroscopy. The live/dead staining, inhibition zone, and the optical degree of co-culture solution demonstrated that the designed surfaces could not only effectively resist bacteria attachment but also kill the surrounding bacteria Escherichia coli and Staphylococcus aureus. It was noteworthy that the strong antibacterial ability could be maintained for more than 5 weeks. Additionally, the excellent hemocompatibility of the modified membranes was confirmed by undetectable plasma protein adsorption, suppressed platelet adhesion, prolonged clotting time, low hemolysis ratio, and suppressed blood-related complement activation. Cell culture tests indicated that the membranes showed no cytotoxicity, but strong anti-cell adhesion properties. The proposed method to fabricate antibacterial hydrogel thin layers has great potential to be widely used to inhibit the formation of biofilms on various biomedical devices.

Preparation of anticoagulant polyvinylidene fluoride hollow fiber hemodialysis membranes

In this study, polyvinylidene fluoride (PVDF) hollow fiber membranes (HFMs) were modified by coating with polyvinyl alcohol (PVA) and chitosan. The influences of PVA and chitosan amount on PVDF membrane mechanical and separation performance were investigated. The results showed that the modified PVDF membranes had better mechanical and separation performance when the amount of PVA and chitosan was 20 mg/m2. At the same time, the biocompatibility of PVDF membranes was also investigated. Compared with virgin PVDF membranes, the modified PVDF membranes showed better anticoagulation, hydrophilicity, less bovine serum albumin (BSA) adsorption, and lower hemolytic ratio. The anticoagulation behavior of modified PVDF membranes coating with PVA had been obviously improved. Prothrombin time (PT) and activated partial thromboplastin time (APTT) of the modified PVDF membrane are 44.8 s and 72.5 s while the PT and APTT of virgin PVDF membrane are 15.6 s and 37.3 s. The advancing water contact angle (WCA) and BSA adsorption of the modified PVDF membrane coating with PVA are 24° and 23 mg/m2 while virgin PVDF membrane is 52° and 49 mg/m2. However, further biocompatibility evaluation is needed to obtain a more comprehensive conclusion.

Engineering of hemocompatible and antifouling polyethersulfone membranes by blending with heparin-mimicking microgels

Enhancing the hemocompatible and antifouling property of polyethersulfone membranes by blending with heparin-mimicking microgels.

Preparation and characterization of novel alkali-resistant nanofiltration membranes with enhanced permeation and antifouling properties: the effects of functionalized graphene nanosheets

In this study, novel alkali-resistant NF membranes were developed by incorporating two kinds of functionalized graphene nanosheets into PES matrix. PES–SG demonstrated more great promise due to its superior permeability and antifouling performance.

Preparation and characterization of a novel benzoxazines/bismaleimide/2,2′-diallylbisphenol A blend with multiphase structures

Novel benzoxazine (BOZ)/bismaleimide (BMI)/2,2′-diallylbisphenol A (BA), with a multiphase structure, was successfully prepared under the catalysis of methyl p-toluenesulfonate (PTSM) through reaction-induced phase separation. The curing reaction of BOZ with BMI and ring-opening polymerization of BOZ under the catalysis of PTSM were studied by Fourier transform-infrared spectroscopy and differential scanning calorimetry analyses, respectively. Mechanical measurements, thermogravimetric analysis, and microanalyses were conducted to assess the toughness and morphology of the composite. The reaction between BOZ and 4,4′-bismaleimidodiphenyl methane (BDM) occurs at a relatively high temperature. The ring-opening reaction of BOZ starts at a low temperature of 100°C because of the catalysis of PTSM. The BOZ/BDM/BA system with an appropriate amount of BOZ significantly improves the impact strength and flexural strength compared with those of the BA/BDM resin. The BOZ/BDM/BA system with PTSM also features high impact strength and flexural strength. Scanning electron microscopy images and energy-dispersive spectroscopy results show that BOZ-rich phase is dispersed in BDM-rich phase in the BOZ/BDM/BA system with PTSM. Thermogravimetric data show that the BOZ/BDM/BA blend with a multiphase structure exhibits superior thermal resistance to those of the BOZ/BDM/BA and BA/BDM resins. The formation mechanism of the ternary system under the catalysis of PTSM is elucidated with Gibbs free energy theory.

Anti-bacterial PES-cellulose composite spheres: dual character toward extraction and catalytic reduction of nitrophenol

Polyethersulfone (PES) based hybrid adsorbents were used for the removal of different phenols from aqueous solutions, which are categorized as major aquatic organic pollutants.

Fabrication and evaluation of polymeric membranes for blood dialysis treatments using functionalized MWCNT based nanocomposite and sulphonated-PES

The use of polyethersulfone based membranes for dialysis therapy is increasing, but the poor bio-compatibility of the PES membrane can raise severe blood reactions affecting the rate of morbidity and mortality of hemodialysis (HD) patients.