DIALYSIS SOLUTIONS INC. PCRRT Conference Orlando, FL June 20th, 2008

CVVH: Bicarbonate vs Lactate Barenbrock M et al, Kid Int 58:1951-1957, 2000 P value Plasma Bicarbonate (mmol/l) 23.7 + 0.4 21.8 + 0.5 < 0.01 Blood Lactate (mg/dl) 17.4 + 8.5 28.7 + 10.4 < 0.05 IV Bicarb given over 24 hrs 13 + 7 68 + 39

CVVH: Bicarb vs Lactate Barenbrock M et al, Kid Int 58:1951-1957, 2000 Dark bar = Bicarb Light bar = lactate

Normocarb HF CRRT SHOULD FIX METABOLIC DISTURBANCES, NOT CAUSE THEM. Normocarb is the right formulation to provide key electrolytes in the physiologically correct concentrations with no unnecessary components and maximum flexibility.

DSI Milestones 1999 – Original Patent for NC35 applied for 2001 July – Walter O’Rourke joins as consultant 2001 December – Normocarb receives FDA 510K approval as device 2002 January – DSI records first US sales of Normocarb 2002 June – Pediatric Nephrology: Pediatric Hemofiltration: Normocarb Dialysate Solution with Citrate Anticoagulation; Bunchman 2002 June – BBraun agreement signed 2002 July – Normocarb receives Canadian DIN 2003 June – Journal of Critical Care: A Novel Regional Citrate Anticoagulation Protocol for CRRT Using Only Commercially Available Solutions; Tobe

DSI Milestones 2003 December – AJKD: Pediatric Convective Hemofiltration: Normocarb Replacement and Citrate Anticoagulation; Bunchman 2005 August – FDA grants Orphan Drug Status to the CRRT indication based on DSI’s application 2006 January – FDA 510K Approval for NC25 2006 May – Canadian Patent issued on NC25 2006 July – DSI receives an NDA for NC25HF/NC35HF 2006 November – DSI launches HF Products 2007 August – DSI receives US patent for 25 bicarb products

Therapy Evolution Diffusion based dialysis requiring device or combination product approved solutions Citrate Hemofiltration dialysis requiring drug approved solutions Volume

Solution Evolution Lactate Buffered – PD Solutions – Dialysate Pharmacy Made – Calcium Containing – Bicarbonate Solutions – Dialysate Citrate Pharmacy Made – Calcium Free – Bicarbonate Solutions – Dialysate Add Mixture Pharmacy Solutions – Calcium Free – Bicarbonate – Dialysate Normocarb – Calcium Free – Dialysate Normocarb NDA as hemofiltration solution for direct infusion

Dialysate vs. Hemofiltration Solution Normocarb HF Dialysate vs. Hemofiltration Solution

Normocarb 35 HF NC 35 HF mEq/L Sodium (Na) 140 Magnesium (Mg) 1.5 Chloride (Cl) 106.5 Bicarbonate (HCO3) 35 Potassium (K) 0 Calcium (Ca) 0

Normocarb 25 HF NC 25 HF mEq/L Sodium (Na) 140 Magnesium (Mg) 1.5 Chloride (Cl) 116.5 Bicarbonate (HCO3) 25 Potassium (K) 0 Calcium (Ca) 0

Normocarb HF Simple Preparation Maximum Flexibility Potassium can be added. Calcium can be added Dextrose can be added