Search

Preparation of dialysate for hemodialysis (or dialysis) requires dilution of the dialysis concentrate with purified water. Present practice contains two steps: first to purify water, and then water is transported to clinic to mix with the dialysate concentrate before treatment. As a new forward osmosis dialysis hybrid process, based on osmotic dilution, is evaluated for decentralized health care systems. A commercial cellulose triacetate (CTA) and a tailor-made thin film composite (TFC) polyamide FO membranes were examined. The rejection of salts in tap water by the FO membranes was investigated, and the real rejections of various ions as a function of permeate flux were well described by using a irreversible thermodynamic model. The hollow fiber TFC FO membrane showed higher water flux and lower reverse salt flux than the CTA membrane in diluting process. Both steric hindrance and electrostatic repulsion explained the rejection behavior of the membranes to the ions. Higher rejections of anions were obtained than cations, which was attributed to the anions selection characteristics of the membranes. No obvious foulings or scalings were observed in a relatively long time osmotic dilution process over 5 repeated cycles. The stable, high efficient osmotic dilution process in hemodialysis holds a strong promise in reducing the consumption of purified water or even eliminating the water purification step. This work provides a potentially new platform hemodialysis which can be portable and implementable away from major hospitals and major clinics. Image 1 • Tap water was used to dilute dialysis concentrate based on forward osmosis. • Ion rejections versus flux were fit well using irreversible thermodynamic model. • Low reverse diffusion of components in dialysis concentrate was found. • Very light fouling after long time osmotic dilution could be cleaned by rinsing with caustic. [ABSTRACT FROM AUTHOR]

Hemodialysis is one of the therapies for patients with kidney failure. Hemodialysis requires large amounts of pure water, and is one of the most water-hungry medical procedures, and thus represents a clear opportunity where improvements should be made concerning the consumption and wastage of water. In this paper, we explored the potential of forward osmosis (FO) membrane for recycling the spent dialysate using the dialysis concentrate as the draw solution. Partially diluted dialysis concentrate could be further diluted with pure water to form dialysate for further dialysis process. Using commercial cellulose triacetate (CTA) FO membranes, the water recovery of approximately 64% was achieved and the final volume of the partially diluted dialysis concentrate was about four times the initial volume. Flux decline of the FO process was observed, mainly due to concentration of synthetic spent dialysate and dilution of dialysis concentrate, while membrane scaling had little impact on the flux decline. The urea rejection was found to be relatively low owing to the small size and electroneutral nature of the urea molecule. Obvious membrane scaling was observed after three FO cycles. The energy dispersive spectroscopy analysis of the scaling layer indicated that the scalants were phosphates and carbonates. The scaling was removed via osmotic backwash and almost completely recovery of FO flux was obtained. Economic analysis showed that the centralized treatment of spent dialysate in a dialysis center using the proposed osmotic dilution process could greatly save water resources and cost. Improving the urea rejection of FO membrane was identified as an important research focus for future research on the potential application of FO technology for recycling the spent dialysate in hemodialysis. Image 1 • Osmotic dilution was used for recycling spent dialysate of hemodialysis. • Decrease in osmotic pressure gradient mainly led to flux decline. • Membrane scaling occurred, but was cleaned by osmotic backwash. • Urea rejection of the FO membrane should be improved. • Centralized treatment of spent dialysate by FO could greatly save water resources and cost. [ABSTRACT FROM AUTHOR]

Hemodialysis consumes significant amounts of pure water and produces large amounts of spent dialysate. Recovering water from spent dialysate is a new attempt in medical industries to save water and costs. The recent proposal of using forward osmosis (FO) to concentrate the spent dialysate showed economic viability. However, there is still one key concern of potentially extended hemodialysis duration because commercial FO membranes have limited urea rejection, which would reduce the urea concentration gradient during hemodialysis. In this paper, a model was developed to quantify the effect of incomplete urea rejection in FO on subsequent hemodialysis duration. The impacts of average urea rejection, water recovery, and the number of hemodialysis sessions were systematically analyzed. Counter-intuitively, the results indicated that relatively low urea rejection of FO membranes actually has little impact on hemodialysis duration. Low urea concentration in the spent dialysate, partial urea rejection by the FO membrane, and further dilution of pre-diluted dialysis concentrate, largely reduces this impact. The result further supports the viability of FO in spent dialysate reuse. Although FO membrane with 100% rejection is expected, the present work indicates that commercial FO membranes with a low rejection of neutral matters are of practical utility in certain applications. • Osmotic dilution was used for recycling spent dialysate of hemodialysis. • A model was developed to evaluate the effect of several factors in the osmotic dilution on the hemodialysis duration. • A relatively low urea rejection of an FO membrane has a minor impact on the subsequent hemodialysis duration. • The reasons for the counter-intuitive result in recycling the spent dialysate by FO were revealed. [ABSTRACT FROM AUTHOR]