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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]