Green nephrology and eco-dialysis: A position statement by the Italian Society of Nephrology
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High-technology medicine saves lives and produces waste; this is the case of dialysis. The increasing amounts of waste products can be biologically dangerous in different ways: some represent a direct infectious or toxic danger for other living creatures (potentially contaminated or hazardous waste), while others are harmful for the planet (plastic and non-recycled waste). With the aim of increasing awareness, proposing joint actions and coordinating industrial and social interactions, the Italian Society of Nephrology is presenting this position statement on ways in which the environmental impact of caring for patients with kidney diseases can be reduced. Due to the particular relevance in waste management of dialysis, which produces up to 2 kg of potentially contaminated waste per session and about the same weight of potentially recyclable materials, together with technological waste (dialysis machines), and involves high water and electricity consumption, the position statement mainly focuses on dialysis management, identifying ten first affordable actions: (1) reducing the burden of dialysis (whenever possible adopting an intent to delay strategy, with wide use of incremental schedules); (2) limiting drugs and favouring "natural" medicine focussing on lifestyle and diet; (3) encouraging the reuse of "household" hospital material; (4) recycling paper and glass; (5) recycling non-contaminated plastic; (6) reducing water consumption; (7) reducing energy consumption; (8) introducing environmental-impact criteria in checklists for evaluating dialysis machines and supplies; (9) encouraging well-planned triage of contaminated and non-contaminated materials; (10) demanding planet-friendly approaches in the building of new facilities.
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Haemodialysis generates considerable quantities of waste (1.5-8 kg per dialysis).
“Haemodialysis is another major resource-hungry procedure generating considerable quantities of waste (1.5–8 kg per dialysis)”
From Waste Management and the Perspective of a Green Hospital—A Systematic Narrative Review (2022) · cites this paper as [22]
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Self-citationIncremental hemodialysis, a valuable option for the frail elderly patient
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Nephrology in the global environment
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Self-citationAmazing and Fantastic Infection Control: The Case of Dialyzer Reuse
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Kaiser seeks San Diego edge with super-green hospital.
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The European Green Deal and nephrology: a call for action by the European Kidney Health Alliance
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Self-citationWaste Management and the Perspective of a Green Hospital—A Systematic Narrative Review
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“In fact, in 2020 the Italian Society of Nephrology presented a position statement on how the environmental impact of caring for patients with kidney diseases could be decreased, suggesting, among others, reducing the burden of dialysis, encouraging the re-use of hospital devices, recycling paper, glass and non-contami…”
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Incremental Versus Standard (Full-Dose) Peritoneal Dialysis
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The osmo-metabolic approach: a novel and tantalizing glucose-sparing strategy in peritoneal dialysis
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Reuse of dialysis reverse osmosis reject water for aquaponics and horticulture
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Self-citationAdvanced hemodialysis equipment for more eco-friendly dialysis
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Towards zero liquid discharge in hemodialysis. Possible issues
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Sustainable kidney care delivery and climate change – a call to action
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Climate Change, Kidney Health, and Environmentally Sustainable Kidney Care
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Self-citationEnvironmental impacts of a Mexican hemodialysis unit through LCA
de Anda, M. H., Taboada-González, P. A., Aguilar-Virgen, Q., Sanchéz, M. V., & Márquez-Benavides, L. (2022) · Journal of Cleaner Production · doi:10.1016/j.jclepro.2022.135480 · Cited by 17 · see citing works
Surgical pathology and sustainable development: international landscape and prospects
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Sustainability in dialysis therapy: Japanese local and global challenge
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Towards zero liquid discharge in hemodialysis. Possible issues
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Informed decision-making in delivery of dialysis: combining clinical outcomes with sustainability
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Transplantation: A Priority in the Healthcare Agenda
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How to improve the environmental impact in haemodialysis: small actions, big changes
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Self-citationGlobal warming applied to dialysis: Facts and figures
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Green Dialysis Review: Reducing Water, Energy, and Waste
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Providing environmentally sustainable nephrology care: focus in low- and middle-income countries
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Assessment of environmental sustainability in renal healthcare
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Many strategies enabling us to optimize kidney care may also be planet friendly
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- Authors
- On the Behalf of Conservative treatment, P. A. A. P. D. P. G. O. T. I. S. O. N., Piccoli, G. B., Cupisti, A., Aucella, F., Regolisti, G., Lomonte, C., Ferraresi, M., Claudia, D., Ferraresi, C., Russo, R., La Milia, V., Covella, B., Rossi, L., Chatrenet, A., Cabiddu, G., & Brunori, G.
- Affiliations
- Centre Hospitalier du Mans (FR)
- University of Pisa (IT)
- University of Parma (IT)
- Ospedale Generale Regionale Francesco Miulli (IT)
- Politecnico di Torino (IT)
- Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari (IT)
- Azienda Ospedaliera G. Brotzu (IT)
- Corresponding author
- Piccoli, Giorgina Barbara
- ORCID
- Venue
- Journal of Nephrology
- Publisher
- Oxford University Press (OUP)
- Published
- 2020-04-15
- Volume
- 33
- Issue
- 4
- Pages
- 681-698
- ISSN
- 1121-8428 (ISSN-L)
- 1724-6059
- PMC
- PMC7381479
- OpenAlex
- W3017075798
- Cited by
- 133
- References
- 162
- Citations by year
- 2026: 21 · 2025: 30 · 2024: 25 · 2023: 22 · 2022: 14 · 2021: 16 · 2020: 5
- FWCI
- 10.69
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Nephrology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Institutional Research Information System (Università degli Studi di Trento) (submittedVersion, cc-by)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion, cc-by)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion, cc-by)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare and Environmental Waste Management
- Health Sciences › Medicine › Nephrology › Dialysis and Renal Disease Management
- Social Sciences › Urban Studies › Healthcare Facilities Design and Sustainability
- Keywords
- environmental impact of dialysis, kidney disease, medication reduction, recycling, water and energy consumption, dialysis machines, sustainable healthcare facilities
- MeSH terms
- Aged, Renal Dialysis, Humans, Italy, Medical Waste, Nephrology
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