{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:39:39Z","timestamp":1793234379375,"version":"4.5.0"},"reference-count":78,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T00:00:00Z","timestamp":1774396800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Toxins"],"abstract":"<jats:p>Extracorporeal dialysis for uremic toxin removal and fluid regulation relies on specialized dialyzers whose membranes differ markedly in polymer chemistry, pore architecture, adsorption capacity, surface bioactivity, and convective performance. These structural and material distinctions result in wide variation in the clearance of chemically diverse uremic solutes. Despite the expanding range of dialyzer options, membrane selection in clinical practice remains largely non-individualized. In this review, we propose a phenotype-based model for dialyzer membrane selection. We outline how distinct membrane families achieve differential solute clearance and integrate these functional characteristics into a framework that considers residual kidney function, nutritional and inflammatory status, cardiovascular physiology, protein-bound toxin burden, and hemodynamic vulnerability. Because access to advanced membranes varies across regions and dialysis providers, implementation will require adaptation to local formulary constraints. Nevertheless, aligning membrane properties with patient-specific toxin profiles offers a promising strategy to optimize extracorporeal therapy and improve outcomes in chronic dialysis.<\/jats:p>","DOI":"10.3390\/toxins18040156","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T12:05:49Z","timestamp":1775563549000},"page":"156","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Membrane-to-Patient Optimization: Individualized Dialyzer Selection for Extracorporeal Dialysis"],"prefix":"10.3390","volume":"18","author":[{"given":"Mariana","family":"Murea","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4468-4446","authenticated-orcid":false,"given":"Alaa S.","family":"Awad","sequence":"additional","affiliation":[{"name":"Division of Nephrology, University of Florida, Jacksonville, FL 32209, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1743-5345","authenticated-orcid":false,"given":"Vandana D.","family":"Niyyar","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Emory University, Atlanta, GA 30322, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3346-7040","authenticated-orcid":false,"given":"Tibor","family":"F\u00fcl\u00f6p","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, SC 29425, USA"},{"name":"Nephrology Section, Medical Services, Ralph H. Johnson VA Medical Center, Charleston, SC 29401, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0347-8742","authenticated-orcid":false,"given":"Akihiro C.","family":"Yamashita","sequence":"additional","affiliation":[{"name":"Department of Chemical Science and Technology, Faculty of Bioscience and Applied Chemistry, Hosei University, Tokyo 184-8584, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7288-2298","authenticated-orcid":false,"given":"Tadashi","family":"Tomo","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Clinical engineering Research Center, Oita University, Oita 879-5593, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9156-5415","authenticated-orcid":false,"given":"Masanori","family":"Abe","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hypertension, and Endocrinology, Department of Internal Medicine, School of Medicine, Nihon University, Tokyo 173-8610, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1056\/NEJMra071313","article-title":"Uremia","volume":"357","author":"Meyer","year":"2007","journal-title":"N. 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