Environmental Impact of Nephrological Activity: How to Register, Evaluate and Audit?

While medical health professionals are trained to detect, treat, and comfort, they are not trained to consider the environmental impact of the services they provide. Healthcare contributes significantly to resource depletion and greenhouse gas emissions. Not only are healthcare institutions, whose mission is to protect and promote health, major polluters that use large amounts of energy and water, but the production, transport, use and disposal of medications and other medical consumables also leave considerable carbon footprints. In nephrology practice, dialysis programs have a particularly large carbon footprint with recurrent, per capita, resource consumption and waste generation profiles that are disproportionately high compared to other medical therapies. A close relationship between renal healthcare professionals and manufacturers is fundamental for the development of sustainable ecofriendly technologies, devices, and machines. Such collaboration is essential to reduce the environmental burden of renal therapies and maintain good quality of treatment. Renal units should register and evaluate their environmental performance and make an initial diagnosis of their environmental processes, to provide locally adapted recommendations for areas of additional improvement through environmental management programs. Regular auditing of these programs must be also performed aiming at continuous improvement with the setting of increasingly ambitious goals for reducing environmental burden of nephrology.