Fluorinated Zirconium-Based Metal-Organic Frameworks as Novel Sorbents to Improve the Efficacy of Hemodialysis Treatment.

People with end-stage chronic kidney disease (CKD) require routine dialysis treatments to remove uremic toxins from the blood in order to minimize toxic symptoms. However, some hydrophobic toxins cannot be effectively removed using conventional hemodialysis techniques, especially when they are bound to plasma proteins. This work reports the first experimental evidence addressing this issue through the incorporation of perfluoroligands into a zirconium-based metal-organic framework, taking advantage of the favorable interactions between fluorine atoms and albumin proteins. The as-designed fluorinated NU-1000 particles (NU@F) demonstrate their capability to remove not only free hydrophobic uremic toxins, specifically p-cresyl sulfate (pCS) and indoxyl sulfate (IS), but also a large fraction of those bound to human serum albumin, notably without causing significant hypoalbuminemia. The NU@F particles incorporated into a cartridge also exhibit good performance under dynamic flow conditions, mimicking the real scenario of hemodialysis. Finally, the NU@F dialysis system is tested in a pooled sample from CKD patients, confirming the actual application potential of the developed prototype system.