The article deals with the issues of renal replacement therapy (RRT) taking into account the latest knowledge in the field of physics and chemistry of polymeric dialysis membranes. Existing and historical information about the classification of membranes for hemodialysis is given. The review also discusses the classification of dialysis membranes, based on the appropriateness of their use for a particular clinical situation, in order to achieve more effective hemodialysis and its modifications, as well as increase the safety of the procedure and reduce episodes of bioincompatibility reactions. The effect of albumin loss during the use of various methods of extracorporeal apparatus detoxification and peritoneal dialysis on the quality of life and survival of patients with end-stage renal disease was evaluated. The mechanisms of protein loss during RRT by adsorption on the hemodialyzer membrane, convective transfer, and elimination into the dialysate are described. In addition, the possibilities of analyzing adsorbed protein fractions under various pathological conditions are presented. The issues of the potentiating effect of hypoalbuminemia as an independent risk factor for adverse outcomes in patients receiving RRT are discussed. Determination of the albumin level and its loss during the procedures for replacing the lost kidney function seems to be a routine method that allows indirect control of basal and energy metabolism, determining the prognosis of treatment with extracorporeal detoxification methods.

Keywords: synthetic dialysis membranes, adsorption of protein fractions, sieving factor, high cut-off membrane, medium cut-off membrane, end-stage renal disease, hemodiafiltration, peritoneal dialysis, hemodialysis, chronic kidney disease, albumin