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Hemoperfusion, a therapeutic technique in which blood is circulated through extracorporeal adsorbents to remove toxins, faces the challenge of simultaneously enhancing the adsorption performance and hemocompatibility of hemoperfusion materials (HPMs) through a facile and eco-friendly surface engineering strategy. Herein, a one-step amyloid-mediated surface modification method is proposed to encapsulate HPMs by immersing them in a phase-transitioned bovine serum albumin (PTB) aqueous solution. The resultant amyloid-like PTB nanocoating modified activated carbon exhibited a nearly four-fold increase in the adsorption capacity for urea and creatinine, as well as significantly enhanced adsorption toward other harmful substances, including heavy metal chromium ion, drug norfloxacin, medium-molecule toxin bilirubin, and large-molecule toxin interleukin-6. Additionally, the hemocompatibility of activated carbon is substantially improved by reducing carbon debris formation, minimizing damage to blood cells, and effectively alleviating non-specific adsorption of plasma proteins while resisting platelet adhesion. The superior blood purification performance was validated in vivo using multiple animal models of chronic kidney disease. Notably, this strategy is broadly applicable to various HPMs, such as polymeric resins and emerging materials such as carbon nanotubes and metal-organic frameworks, offering an effective and highly general surface engineering approach to enhance the performance of various blood purification materials with significant clinical implications.

https://doi.org/10.1002/adma.73480