A website calculator to benchmark the carbon footprint of haemodialysis

Background

Haemodialysis (HD) contributes vastly to greenhouse gas (GHG) emissions. Recognizing this, the German Society for Nephrology initiated a web-based carbon footprint assessment tool to benchmark emissions.

Methods

This study collected data from five pilot HD centres between 2015 and 2023. Emission categories appropriate for HD were defined and included transportation, energy consumption, manufacturing/disposal and other operational factors.

Results

The all-centre, all-period average was 3.72 ± 0.44 tons of carbon dioxide equivalents per patient per year, with manufacturing/disposal, energy consumption and patient transportation as the largest contributions. Over the assessment period, a reduction of 9.1% was achieved, through changes in dialysate flow (−0.16 tons/patient/year), solar power system installation (−0.21 tons/patient/year) and transition to a planetary health–adapted diet (−0.10 tons/patient/year). A best-case scenario with modelled implementation of all ready-to-use measures, including 40% of patients switching to automated peritoneal dialysis and 10% to incremental HD, projected a reduction potential of 38.7% or 1.5 tons/patient/year, substantially less than what is needed to reach net zero.

Conclusions

Using available technology, HD-related GHG emissions were reduced by 9% in the short term. Higher future reductions to meet the targets of a 50% reduction by 2030 and net zero by 2045 might necessitate enhancing prevention and transplantation efforts, technological innovation, support chain adaptations and structural changes like increased use of peritoneal dialysis.