BACKGROUND/AIMS: Because longer and/or more frequent dialysis has potential clinical benefits, home hemodialysis (HHD) systems should provide flexible renal replacement therapies. We propose a new cold dialysate regeneration system that requires 10 l per treatment for HHD. METHODS: We designed a dialysate regeneration system using cold dialysate and 2 activated carbon columns alternatively switched between adsorption and desorption. Urea adsorption ratios were compared in three different conditions; cold dialysate (5.7 degrees C), normal dialysate (36.8 degrees C), and cold dialysate with washing. In vivo tests (n = 8) were conducted to validate this system. RESULTS: The urea removal ratios were 20.0 +/- 1.7% in cold dialysate, 36.0 +/- 1.7% in normal dialysate, and 82.5 +/- 1.2% in cold dialysate with washing. In animal experiments, the urea reduction ratio was 60.9 +/- 6.3%, Kt/V was 1.0 +/- 0.2, and serum electrolytes remained stable. CONCLUSION: The proposed cold dialysate regeneration system using a small volume of dialysate will be useful for HHD.
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