Green Nephrology in Home Haemodialysis

Green nephrology has gained significant interest in the last two decades, with increasing attention paid to the environmental impacts of healthcare and the reciprocal impact this has on health. In the landscape of the increasing prevalence of chronic kidney disease, great emphasis has been placed on healthcare provision and improving dialysis techniques and access to dialysis. Haemodialysis (HD) involves high water usage and energy consumption and generates large amounts of waste, collectively increasing the carbon footprint of dialysis. Performing HD at home can lower the environmental impact of treatments by reducing the need for travel, using individualised treatment prescriptions to reduce consumption, and providing a framework for water and waste recycling and the use of renewable forms of energy to begin on a smaller scale. In this chapter, we describe the resource-intensive process of haemodialysis, discuss methods for conservation in the home haemodialysis setting in more detail and explore the work and innovation that could still be done on an individual, industrial and legislative level to boost environmental sustainability.