<p>The European Kidney Health Alliance’s 2023 annual Policy Forum brought together relevant stakeholder groups and examined the impact of the environment on kidney health and of kidney replacement therapies on the environment; the environmental footprint of kidney care; and the role of the European Union (EU) in facilitating the transition to sustainable healthcare. Interventions made by nephrologists, patient representatives, renal nurses, scientists, civil society representatives, medical technology specialists, and EU policymakers and administrators considered themes that included the burden of chronic kidney disease (CKD) in the EU, the link between kidney health and environment, waste production and resource use, organ transplantation, technological innovation, and the role that the EU has to play in addressing the burden of kidney disease and fostering more sustainable healthcare practices. The 2023 European Kidney Forum illustrated the broad consensus among diverse stakeholders operating within the kidney health landscape on the critical need to adopt a more sustainable approach to kidney care in the EU. The Forum also highlighted the cruciality of EU policymakers’ commitment to improving the sustainability of the healthcare sector through EU policies, tools and initiatives. Panel discussions pointed to the strong consensus between different stakeholders in the kidney health domain on the need for action to better prevent chronic kidney disease; improve the EU’s organ donation and transplantation landscape; and recognise and address the substantial environmental impact linked to the management and treatment of CKD.</p> Graphical abstract <p></p>