John Agar and Katherine Barraclough have produced a fantastic review looking at the impacts of environmental change on kidney health as well as the environmental damage caused by kidney services (especially dialysis) and strategies to mitigate this.
Strategies discussed in haemodialysis include recycling reverse osmosis reject water, reducing dialysate flow rates, utilising renewable energy sources and optimising waste management; in peritoneal diaylsis, the opportunities from point-of-care dialysate generation are considered.
The article calls for improved monitoring of dialysis resource usage and waste generation, widespread uptake of environmental improvement opportunities by dialysis facilities, increased environmentally themed research and a greater focus on preventative care.
This should be a theme paper for the kidney care community worldwide in 2020.
Barraclough, K.A., Agar, J.W.M. Green nephrology. Nat Rev Nephrol(2020). https://doi.org/10.1038/s41581-019-0245-1
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