Dialysis system

A medical system, comprising:

• a filtration system capable of filtering a water stream;
• a water purification system, capable of purifying the water stream in a non-batch process comprising a microfluidic heat exchange system having a fluid pathway comprising
• (a) a first region comprising a water inlet where water flows in a first direction at a first temperature;
• (b) a heater region downstream of the first region, comprising at least one heater to heat water flowing through the heater region to a second temperature greater than the first temperature and at least 138° C.;
• (c) a dwell chamber downstream of the heater region wherein the water remains within the dwell chamber at or above the second temperature for a predetermined amount of time effective to produce a concentration of less than 10−6 colony forming units per milliliter;
• (d) a second region downstream of the dwell chamber where water flows in a second direction at a temperature greater than the first temperature, wherein water flowing in the second region thermally communicates with water flowing in the first region such that heat transfers from water flowing in the second region to water flowing in the first region resulting in a temperature reduction in the water as it flows through the second region, so that water flowing out of the pathway through a water outlet is at a temperature less than the second temperature;
• a mixing system capable of producing a stream of dialysate from mixing one or more dialysate components with purified water from the water stream in a non-batch process;
• and
• a dialyzer system, comprising
• a microfluidic or flow field dialyzer fluidly coupled to the stream of dialysate and a blood stream, the dialyzer comprising a membrane separating the stream of dialysate from the blood stream, the membrane facilitating dialysis of the blood stream;
• at least one pump capable of pumping the stream of dialysate across the dialyzer;
• and
• a controller operatively coupled to at least one pump, the controller capable of controlling a flow rate of the dialysate stream through at least one pump to perform water ultrafiltration, hemodiafiltration on the blood stream while the blood stream is undergoing dialysis, or both.