β -CD-polyethyleneimine hybrid alginate macrospheres for the efficient removal of indoxyl sulfate

Abstract Indoxyl sulfate (IS), one of protein bound uremic toxins, is associated with various complications in chronic kidney disease patients and could partially be removed through hemodialysis and hemoperfusion due to its high affinity to human serum albumin. Many studies have demonstrated the potential for blood purification applications, such as poly- β -cyclodextrin (PCD) and metal–organic frameworks, providing new possibilities for the efficient removal of IS. Here, we utilized β -cyclodextrin ( β -CD)-grafted polyethyleneimine (PEI), which is referred to as β P, as a scavenger for IS and sodium alginate (SA) as the matrix material to prepare alginate-based hybrid macrospheres (MS). The surface polydopamine (PD) and argatroban (AG) modification resulted in enhanced biocompatibility and anticoagulation. The results indicated that the hybrid MS demonstrated effective adsorption and removal capacity (79.96%) of IS. Moreover, the lower hemolysis rate (0.36%) and longer anticoagulation-related factors (APTT: 161.5 s; TT, 35.6 s) also revealed favorable biocompatibility and anticoagulation. This study presents a new way to designate blood purification materials and highlights their potential in clinical hemoperfusion treatment.