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. 2024 Aug 1;35(8):1084-1094.
doi: 10.1681/ASN.0000000000000402. Epub 2024 May 20.

Climate Change, Kidney Health, and Environmentally Sustainable Kidney Care: A Multinational Survey of Health Care Professionals

Shaifali Sandal  1   2 , Isabelle Ethier  3   4 , Ugochi Onu  5 , Winston Fung  6 , Divya Bajpai  7 , Workagegnehu Hailu Bilchut  8 , Peace Bagasha  9 , Letizia De Chiara  10 , Ehab Hafiz  11 , Brendan Smyth  12 , Dearbhla Kelly  13 , Maria Pippias  14   15 , Vivekanand Jha  16   17   18
Affiliations

Climate Change, Kidney Health, and Environmentally Sustainable Kidney Care: A Multinational Survey of Health Care Professionals

Shaifali Sandal et al. J Am Soc Nephrol. .

Abstract

Key Points:

  1. A multinational survey of health care professionals on the kidney health impacts of climate change and the environmental burden of kidney care was conducted.

  2. Most participants reported knowledge gaps and high level of concern on these interconnected issues.

  3. Only a minority report personal or organizational initiatives in environmentally sustainable kidney care; this did not vary by country income level.

Background: Given the threat of climate change to kidney health and the significant environmental effect of kidney care, calls are increasing for health care professionals and organizations to champion climate advocacy and environmentally sustainable kidney care. Yet, little is known about their engagement, and existing literature is primarily emerging from high-income countries.

Methods: We conducted a cross-sectional survey to understand the knowledge, attitude, and practice of health care professionals on the interconnectedness of climate change and kidney health; to identify personal and organizational initiatives in sustainable kidney care and strategies to increase their engagement; and to compare responses by their country's income level as classified by the World Bank.

Results: Participants (n=972) represented 108 countries, with 64% from lower- or middle-income countries. Ninety-eight percent believed that climate change is happening, yet <50% possessed knowledge about the effect of climate change on kidney health or the environmental effect of kidney care. Only 14% were involved in climate change and kidney health initiatives (membership, knowledge/awareness, research, and advocacy), 22% in sustainable kidney care initiatives (education/advocacy, preventative nephrology, sustainable dialysis, promoting transplant/home therapies, and research), and 26% reported organizational initiatives in sustainable kidney care (sustainable general or dialysis practices, preventative/lean nephrology, and focused committees). Participants from lower-income countries generally reported higher knowledge and variable level of concern. Engagement in sustainable kidney care did not vary by income level. Guidance/toolkit (79%), continuing education (75%), and opportunities (74%) were the top choices to increase engagement. National initiatives (47%), preventative measures (35%), and research endeavors (31%) were the top avenues for organizational engagement. These varied by income level, suggesting that the vision and priorities vary by baseline resource setting.

Conclusions: We have identified knowledge and practice gaps among health care professionals on the bidirectional relationship between kidney disease and climate change in a multinational context and several avenues to increase their engagement.

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Conflict of interest statement

Disclosure forms, as provided by each author, are available with the online version of the article at http://links.lww.com/JSN/E709.

Figures

None
Graphical abstract
Figure 1
Figure 1
Health care professionals and their engagement in climate advocacy and environmentally sustainable kidney care. (A) Are you involved in any initiatives to combat the effects of climate change on kidney health in your region? (B) Are you involved in any initiative/s to make nephrology care more sustainable? (C) Please pick the resources that could potentially increase your engagement in environmentally sustainable kidney care.
See this image and copyright information in PMC

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