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However, its long\u2010term efficacy is fundamentally constrained by the performance of dialysis membranes. Conventional polymeric membranes, primarily optimized for removing small solutes, are inadequate for clearing middle\u2010molecular\u2010weight and protein\u2010bound uremic toxins (PBUTs), which drive chronic inflammation, cardiovascular dysfunction, and dialysis\u2010related 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. 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