Addressing the Environmental Impact of Kidney Care

Abstract

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Increasing Dialysate Flow Rate over 500 ml/min for Reused High-Flux Dialyzers do not Increase Delivered Dialysis Dose: A Prospective Randomized Cross Over Study

“…17 Reducing in water consumption will also decrease waste water production and electrical consumption, and these have a positive effect on the environment and carbon emissions, which has been recently concerned in dialysis practice as green nephrology and eco-dialysis. 17,18 However, increasing the Qd beyond 500 ml/min should be considered in selected patients who have not achieved HD adequacy despite using an appropriate dialyzer KoA and optimized Qb, especially in patients with high body weight. Second, reusing a dialyzer up to 15 times does not affect dialysis efficiency and provides adequate dialysis therapy as long as adequate anticoagulation throughout HD session and high residual TCV are maintained.…”

Policy and Kidney Community Engagement to Advance toward Greener Kidney Care

“…Similar efforts in the United States to support systematic data collection and iterative improvement in environmental footprint could be integrated into Quality Improvement and Performance Assurance initiatives under the Conditions for Coverage for dialysis facilities. This strategy would almost certainly entail upfront costs to these facilities, such as metering equipment and training staff, but precedent on the basis of efforts in other countries suggests that these initial investments are likely to result in future cost savings 6 …”

“…This strategy would almost certainly entail upfront costs to these facilities, such as metering equipment and training staff, but precedent on the basis of efforts in other countries suggests that these initial investments are likely to result in future cost savings. 6…”

“…Collaboration among multiple stakeholder groups—including people with kidney disease, their clinicians, professional societies, patient associations, dialysis organizations, and industry—will be foundational to these efforts. Legislative and regulatory policies are needed at the local, state, national, and international levels to coordinate these groups around common goals 4 , 6 . Specifically, policy may be designed to support members of the kidney community in investigating current resource utilization, developing and implementing systematic tracking of environmental effect over time, and investing in green care processes and technological innovations.…”

Sustainable kidney care delivery and climate change – a call to action

“…Moreover, the incidence of dialysis has increased by 43% between 1990 and 2017 [ 2 ], and more than 5 million people globally are estimated to require haemodialysis treatment by 2030, driven by rising prevalence of CKD and its risk factors such as diabetes and obesity [ 8 ]. Yet, many healthcare professionals may not realise the enormous scale of environmental impact of haemodialysis, and more importantly, the opportunities that exist for improvement [ 9 ].…”