Why go green?

Nephrology practice has a high environmental impact

1. The healthcare industry contributes significantly to greenhouse gas emissions and natural resource depletion
2. Dialysis programs per capita resource consumption and waste generation is the highest in healthcare
3. The environmental price of dialysis is high. An Australian study has shown the annual per patient carbon footprint of satellite conventional haemodialysis to be 10.2 tonnes CO2-equivalents (t CO2-eq) … more than half the Australian mean annual per capita CO2 emission estimate of 18.8 t CO2-eq
4. The financial price is also high. The cost to the Australian Government of treating end-stage kidney disease (2009 to 2020) was estimated at $12 billion
5. The ‘world’ dialysis population (estimated ~2.5 million patients in 2011) would annually consume …

• ~156 billion litres of water
  
• ~1.62 billion kWh of power
  

… and would create…

• ~625,000 tonnes of plastic waste

Climate change will increase the burden of renal disease

Climate change occurring as a result of human activity will have potentially devastating effects on health and has been identified as the greatest global health threat of the 21^st century.

These health effects will be broad and disproportionately impact vulnerable populations.

Climate change is likely to:

• directly increase the burden of renal disease
• increase hospital admissions from AKI during heat waves
• cause cyclical dehydration and contribute to the epidemics of CKD
• promote nephrolithiasis
• increase diarrhoeal illness and vector borne disease spread as a result of increased flooding
• destabilize the provision of health care to patients with kidney disease
• disrupt the supply of clean water and power for haemodialysis through extreme weather events
• inhibit the transport of supplies
• interrupt patient access to haemodialysis and peritoneal dialysis.

A full review of the global impacts of climate change on the renal community is available in Kidney International.

Sustainable practice can deliver broad benefits

International experience has already demonstrated broad benefits of environmental initiatives within the nephrology sector.

In the UK, the Green Nephrology (GN) Network was established (2009) by the National Health Service Sustainable Healthcare Programme. It has has led to both attitudinal and practice change

The GN Network estimates the annual savings to be:

• 470 million litres of water.
• 11,000 t CO2-eq of greenhouse gases.
• savings of £7 million from GN innovations.
• savings of ~£1 billion/year if ‘the same enthusiasm and focused work were to be spread across the whole NHS’

The renal community has duty of care to minimise harm and protect and promote a safe and healthy environment.

Sustainable dialysis can and must become a global goal:

• Encouraging the re-use and re-cycling of reject water.
• Promoting the introduction of renewable energy options.
• Ensuring the re-cycling of plastic waste materials.
• Finding ways to reduce the carbon footprint of renal healthcare.