Preparation of zwitterion-decorated carbon nanotubes/ZIF-8 composite aerogel beads as an effective adsorbent for protein-bound uremic toxins removal in hemoperfusion

Eliminating protein-bound uremic toxins (PBUTs), which are difficult to be removed by dialysis, from the patients by using hemoperfusion therapy would become a practical strategy for kidney diseases (KDs) treatment once the specific adsorbent could meet the following requirements, such as large PBUTs removal capacity, low beneficial protein adsorption, and excellent biocompatibility, etc., simultaneously. Herein, inspired by the efficient antifouling efficacy by zwitterionic grafting, we developed a novel trimethylamine-N-oxide (TMAO) analogue-decorated carbon nanotubes (T-CNTs)/ZIF-8 composite bead for PBUTs removal. Owing to the radial macropores as diffusion channels in the aerogel beads created by freeze casting, TMAO modified T-CNTs as the anti-protein-adsorption component, porous ZIF-8 as the main adsorption component for PBUTs, and particularly, the effective dissociation of PBUTs-protein complex by the synergistic effect of T-CNTs and ZIF-8, efficient PBUTs removal capacities of 67.24, 147.63, and 74.29 mg g −1 for indoleacetic acid, hippuric acid and indoxyl sulfate were achieved, respectively. Moreover, the T-CNTs/ZIF-8 aerogel beads also exhibited high hemocompatibility along with low cytotoxicity in biocompatibility tests, demonstrating them might be a promising candidate for future hemoperfusion therapy toward KDs treatment in clinical trials.