4.6 Article

The European Green Deal and nephrology: a call for action by the European Kidney Health Alliance

Journal

NEPHROLOGY DIALYSIS TRANSPLANTATION
Volume 38, Issue 5, Pages 1080-1088

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/ndt/gfac160

Keywords

circular dialysis concept; ecology; environment; green nephrology; waste control

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This article emphasizes the mutual impact of climate change on kidney health and kidney care on ecology. It proposes a range of solutions, including measures to reduce water consumption, implement energy-neutral policies, waste triage, and material recycling, to address the ecological burden caused by nephrology care.
The world faces a dramatic man-made ecologic disaster and healthcare is a crucial part of this problem. Compared with other therapeutic areas, nephrology care, and especially dialysis, creates an excessive burden via water consumption, greenhouse gas emission and waste production. In this advocacy article from the European Kidney Health Alliance we describe the mutual impact of climate change on kidney health and kidney care on ecology. We propose an array of measures as potential solutions related to the prevention of kidney disease, kidney transplantation and green dialysis. For dialysis, several proactive suggestions are made, especially by lowering water consumption, implementing energy-neutral policies, waste triage and recycling of materials. These include original proposals such as dialysate regeneration, dialysate flow reduction, water distillation systems for dialysate production, heat pumps for unit climatization, heat exchangers for dialysate warming, biodegradable and bio-based polymers, alternative power sources, repurposing of plastic waste (e.g. incorporation in concrete), registration systems of ecologic burden and platforms to exchange ecologic best practices. We also discuss how the European Green Deal offers real potential for supporting and galvanizing these urgent environmental changes. Finally, we formulate recommendations to professionals, manufacturers, providers and policymakers on how this correction can be achieved.

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