This project develops an advanced, portable hemodialysis regeneration system that significantly enhances the quality of life of end-stage renal disease (ESRD) patients. ESRD impairs physiological systems and functions, and is associated with disability, high morbidity and mortality. Hemodialysis is prescribed for the majority of individuals in the final stages of renal failure. Minimizing the loss of nutrients and improving dialysis delivery (length, frequency, and location) enables individuals with ESRD to feel better, have more energy, work more, and engage in activities in their communities. Project investigators use surface chemistry and material science techniques to develop an advanced dialysate regeneration system able to remove a broad spectrum of uremic toxins while minimizing the loss of nutrients such as amino acids, vitamins, and essential ions. Technical objectives include: (1) performing scale-up production of the components of the advanced dialysate regeneration system (DRS-2); (2) designing and constructing the prototype module (cartridge) to house the DRS-2; (3) proving the safety and efficacy of the DRS-2 in vitro; (4) performing overall efficacy and quality tests of the DRS-2 using spent dialysate; and (5) evaluating and summarizing Phase II processes and results.