Gallic acid carbon dot-supported heparin-like polymer as an optimized membrane-anchored anticoagulant for functionalization of hemodialysis membranes.

Conventional hemodialysis membranes exhibit suboptimal blood compatibility, predisposing patients to thrombotic events and oxidative stress-associated complications that accelerate disease progression. To address this challenge, we developed a gallic acid carbon dots (GA-CDs)-functionalized polyethersulfone (PES) membrane via polydopamine-assisted co-deposition of nitrogen-doped GA-CDs and a heparin-mimetic polymer. The resulting membrane features stable surface immobilization of GA-CDs, conferring durable hemocompatibility and intrinsic dual functionality: (i) sustained ROS-scavenging-driven antioxidant activity for long-term oxidative stress mitigation; and (ii) enhancement of anticoagulant performance through suppression of oxidative stress-mediated tissue factor (TF) activation, thereby synergistically preventing thrombosis. Mechanistically, GA-CDs activated the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling cascade to upregulate endogenous antioxidant enzymes, efficient reactive oxygen species (ROS) clearance, and protection against oxidative cellular damage. Concurrently, by scavenging ROS, GA-CDs suppressed oxidative stress-induced tissue factor activation, establishing a functional link between redox homeostasis and coagulation regulation. In vitro evaluation demonstrated outstanding dual functionality: potent free radical scavenging capacity (83% DPPH and 97% ABTS⁺ scavenging), significantly prolonged activated partial thromboplastin time (APTT 420 s, 8.4-fold increase vs. control), excellent cytocompatibility, and markedly improved hemocompatibility. Collectively, these findings highlight the translational promise of this rationally designed dual-action hemodialysis membrane, where localized durable ROS scavenging and surface-confined anticoagulation operate in concert to mitigate key pathophysiological drivers of dialysis-associated complications.