Chronic kidney failure patients are steeply increasing worldwide. In-center hemodialysis (HD) has become the standard treatment, but this has raised many problems. Most patients suffer from harsh dietary restrictions and severe complications, resulting in an unacceptably high rate of mortality: 65% over 5 years. Due to the dialysis schedules (three times a week), travel arrangements and participation in social activities are strictly limited. Commuting to the dialysis center and waiting for treatment can take several hours, exhausting patients and their families. Portable or home HD solves these issues, but the bulk and the daily maintenance required for the conventional HD units make using the hemodialysis at home (or at a battlefield) impractical. Manufacturing ~140 liters of ultrapure dialysate is a big obstacle that prohibits the hemodialysis from being implemented outside the clinic. With this said, a new hemodialysis unit — the xKidney, which is optimized for portable and home use, has been developed. The complex dialysate compartment and the mandatory disinfecting process are eliminated, and the entire dialysate flowing passages are made disposable. This was achieved by patented active Piston Balancing (aPB) pumping technology where a single pump replaces all of the functions of the blood pump, dialysate pumps, and the balancing chamber. Accordingly, the entire xKidney unit is far more portable, and the patient or medical personnel can conduct hemodialysis with ease whenever and wherever necessary.