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. 2023 Jun 5:1–10. Online ahead of print. doi: 10.1038/s41581-023-00726-9

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© Springer Nature Limited 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

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Fig. 1 — a, Single-pass haemodialysis is the most common modality of kidney replacement therapy, but requires very large volumes of dialysate, which limits the portability of the system. b, Portable and/or wearable haemodialysis devices use dialysate regeneration systems based on chemical sorbents, urease, electro-oxidation, photo-oxidation or combinations of these approaches. c, Haemodialysis can also be performed using an implantable dialysis filter (typical Si-wafer based) with an external regenerative dialysate circuit. d, Fully implantable artificial kidneys are also being developed. These systems use a silicon-wafer filter as an artificial glomerulus in combination with an artificial tubule module (which might be a bioreactor or a fully technological approach) that has a urine outlet to the bladder. e, Single-pass peritoneal dialysis also uses large volumes of dialysate (image shows typical tidal peritoneal dialysis). f, Peritoneal dialysis can also be miniaturized using dialysate regeneration systems. This approach is suitable for continuous flow peritoneal dialysis.