There is an urgent need to develop an efficient technique to remove urea from the blood or gastrointestinal tract of uremic patients. Activated charcoals have a low sorption capacity for urea although they effectively remove other uremic toxic substances. To provide an urea-reactive adsorbent, a chemically modified oxystarch with albumin or gelatin has been prepared. Elemental analysis and Fourier transform infrared (FT-IR) spectroscopic analysis demonstrate that the reaction of a small amount of protein (albumin or gelatin) with oxystarch has taken place possibly by chemical combination. The influence of the dialdehyde content of the oxystarch on urea sorption, its sorption isotherm, and the adsorption rates have been investigated. It was found that the swelling factor of the oxystarch is closely related to the sorption activity under physiological conditions (pH 7.2-7.4 at 37 degrees C). Adsorption studies have shown that sorption capacity is increased by surface treatment and can reach 6-8.2 g urea/kg-dried adsorbent (initial urea concentration was 70 mg/dL). The oxystarch had 49.2% of glucose unit oxidized and was surface treated with albumin. These results suggest that the newly prepared surface-treated oxystarch would be utilized as an effective chemisorbent for urea removal under physiological conditions.