Environmental nephrology and sustainable kidney care

🌱 Environmental Nephrology and Sustainable Kidney Care – ERA Neph-Manual 2025 Chapter Summary

This foundational chapter, authored by Maaike van Gelder, Frances Mortimer, Peter Blankestijn, and Karin Gerritsen, outlines a bold, evidence-based roadmap for making kidney care more sustainable — environmentally, socially, and economically.

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:

• Clinicians can implement greener dialysis workflows.
• Industry must innovate with circularity and life-cycle thinking.

• Healthcare systems should mainstream environmental metrics into procurement and reporting.

  🟢 Read the full chapter (free for ERA members) via the ERA eLearning platform:
  👉 https://e-learning.era-online.org/ebook/environmental-nephrology-and-sustainable-kidney-care

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.