If you want to work in the algebraic category you should think about an algebraic notion of flow. If $M$ is a smooth manifold then a flow is an $\mathbb{R}$-action $\mathbb{R} \times M \to M$; dualizing this map gives a coaction $C^{\infty}(M) \to C^{\infty}(\mathbb{R}) \otimes C^{\infty}(M)$ where by $\otimes$ I mean a suitably completed tensor product. (Note that the group structure on $\mathbb{R}$ gives $C^{\infty}(M)$ a Hopf algebra structure, at least with respect to a suitably completed tensor product as above, so we can talk about comodules over it.)

So the most algebraic notion of flow would be a "polynomial flow," namely a coaction $A \to k[t] \otimes_k A$, where $A$ is a $k$-algebra and we are thinking of $k[t]$ in its incarnation as the ring of functions on the additive group scheme $\mathbb{G}_a$ over $k$. In fact in this language a derivation is precisely a coaction $A \to k[t]/t^2 \otimes_k A$ and the problem of integrating this to a flow is a lifting problem. 

A sufficient condition for a polynomial flow to exist is that the original derivation $D$ be nilpotent, but you knew that already. A more interesting sufficient condition is that it be locally nilpotent in the sense that for every $a \in A$ there is some $n$ such that $D^n a = 0$. For example this is true of the derivation $\frac{\partial}{\partial x}$ on $k[x]$. I think this condition is also necessary when $A$ is an integral domain.

There are variations on this theme, e.g. we can talk about formal flows $A \to k[[t]] \otimes_k A$ but these always exist in characteristic zero (formally exponentiate) so this is in some sense uninteresting. Replacing $k[[t]]$ with other variations of $k[t]$ give other notions of flow. 

For example, to talk about flows on smooth manifolds in this algebraic language we should really talk about <a href="http://ncatlab.org/nlab/show/smooth+algebra">smooth algebras</a>. Smooth algebras admit a smooth tensor product (this is the suitably completed tensor product I wanted) with respect to which $C^{\infty}(M) \otimes C^{\infty}(N)$ really is just $C^{\infty}(M \times N)$, and in particular $C^{\infty}(\mathbb{R})$ really is a Hopf algebra in the category of smooth algebras.

Now a flow is a coaction $A \to C^{\infty}(\mathbb{R}) \otimes A$, and these exist for smooth compact manifolds but also for other smooth algebras, e.g. any embedding of a finite-dimensional real commutative algebra $A$ into a real matrix algebra gives it a smooth algebra structure and all derivations on such things exponentiate to smooth flows.