In the past 20 years, awareness of the huge environmental impact of kidney care has increased considerably. Although opportunities to reduce this impact have been identified and innovative approaches developed, implementation of these strategies remains slow. System-wide action is urgently required to improve the sustainability of kidney care.
Our planet is in crisis. Greenhouse gas emissions are accelerating climate breakdown; pollution is contaminating air, land and water; and biodiversity is collapsing. As the natural systems that sustain life unravel, human health is increasingly at risk. Environmental factors — including unsafe air, water, food and climate — already contribute to one in four deaths globally1, and climate change is projected to cause an additional 14.5 million deaths by 2050 (ref. 2). The incidence and distribution of kidney disease is also expected to increase as environmental change accelerates.
Efforts to confront these challenges are underway, and some progress is being made. Yet, despite widespread recognition of the scale of the crisis, global action remains fragmented and inadequate, and business as usual persists. This disconnect is mirrored in nephrology. Awareness of the environmental impact of kidney care is growing and opportunities to reduce harm have been identified, but implementation remains slow. Promising innovations are emerging, but in most settings, funding and readiness for adoption continue to lag far behind.