Environmental Nephrology and Sustainable Kidney Care

Recognizing that healthcare contributes approximately 5% of global greenhouse gas emissions, the authors call for urgent action in nephrology, where dialysis alone has a disproportionately high environmental footprint. A single haemodialysis session can use over 500 litres of water, 10 kWh of energy, and generate significant waste.

🔍 Key themes and strategies include:

  • Prevention over intervention: Slowing CKD progression through early detection, patient empowerment, and conservative management is the most sustainable intervention.
  • Innovation with impact: From regenerative dialysate systems and home-based therapies to renewable energy integration, the chapter showcases a wide range of technologies (with TRLs) ready for implementation or scale-up.
  • Rethinking resource use: Life Cycle Assessments (LCAs) and carbon footprint comparisons reveal the variable impacts of HD and PD across different contexts, underscoring the need for localized data and smarter design.
  • Systems change: Embedding sustainability in procurement, prescribing, education, and health policy is essential. The authors champion the use of the SusQI framework to integrate sustainability into quality improvement initiatives.

📌 The chapter is a call to action for every stakeholder:

This living document not only synthesizes current knowledge but also sets a dynamic agenda for research, innovation, and action. It’s a must-read for anyone striving to align kidney care with planetary health.

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