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Review
. 2025 Jan;38(1):87-99.
doi: 10.1007/s40620-024-02114-3. Epub 2024 Nov 8.

Improving the sustainability and quality of kidney health care through life cycle assessments, quality improvement, education and technical innovations: the KitNewCare approach

Brett Duane  1 , Ingeborg Steinbach  2 , Rachel Stancliffe  2 , Stefi Barna  2 , David Cameron  2 , Ilaria de Barbieri  3 , Edita Noruisiene  4 , Frances Mortimer  5 , Karin Gerritsen  6 , Raymond Vanholder  7 , Gabriele Donati  8 , Gaetano Alfano  9 , Jolanta Malyszko  10 , Giulia Ligabue  8 , Bridget Johnston  11 , Mary Louise Wratten  12 , Marialuisa Caiazzo  12 , Elisabeth Schmid  13 , Alberto Ortiz  14
Affiliations
Review

Improving the sustainability and quality of kidney health care through life cycle assessments, quality improvement, education and technical innovations: the KitNewCare approach

Brett Duane et al. J Nephrol. 2025 Jan.

Abstract

The European Union (EU)-funded KitNewCare consortium aims to create and manage a comprehensive EU-wide programme focusing on sustainability in Kidney Care. Around 850 million people have chronic kidney disease (CKD) worldwide and by 2030, 6 million will need kidney replacement therapy, mainly haemodialysis. As the world population gets older, projections for the end of the century worsen. From a sustainability perspective, healthcare systems contribute around 5-11% of total carbon emissions. Kidney care is one of the most resource-intensive specialties. In addition to energy, haemodialysis and peritoneal dialysis require transportation of patients and personnel to and from facilities, use large volumes of water and generate significant plastic waste. Overall, current dialysis is not sustainable in the medium term. Primary prevention, early diagnosis and treatment of CKD and transplantation will decrease the need for dialysis, but this will take time and will not prevent the need for dialysis in millions of persons. There is a need to improve knowledge around the environmental and financial cost of kidney care and social and health outcomes of each patient pathway including using holistic tools such as life cycle assessment. This knowledge will allow workflow optimisations, organisational transformations and technological innovations across Europe, learning from different clinical sites. KitNewCare will build a European-wide knowledge base for sustainability in kidney care, develop and introduce a novel 4-factor database for comprehensive impact analysis, implement optimised processes and organisational transformations in four European clinical sites. It will also pilot innovations from small- and medium-sized high-tech enterprises with a focus on kidney care, and establish a network for continuous monitoring, benchmarking, and implementation of sustainable solutions across healthcare sectors. This paper presents the rationale behind selecting kidney disease as a focal point, summarises the current state of knowledge, and outlines the foundational statement underlying KitNewCare's operational framework.

Keywords: Dialysis; Environmental burden; Green nephrology; Kidney care; Kidney replacement therapy; Sustainability.

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Conflict of interest statement

Declarations. Conflict of interest: Alberto Ortiz has received grants from Sanofi and consultancy or speaker fees or travel support from Adviccene, Alexion, Astellas, Astrazeneca, Amicus, Amgen, Boehringer Ingelheim, Fresenius Medical Care, GSK, Bayer, Sanofi-Genzyme, Menarini, Mundipharma, Kyowa Kirin, Lilly, Freeline, Idorsia, Chiesi, Otsuka, Novo-Nordisk, Sysmex and Vifor Fresenius Medical Care Renal Pharma and Spafarma and is Director of the Catedra UAM-Astrazeneca of chronic kidney disease and electrolytes. He has stock in Telara Farma. AO research is also funded by Instituto de Salud Carlos III (ISCIII) FIS/Fondos FEDER RICORS program to RICORS2040 (RD21/0005/0001) funded by European Union – NextGenerationEU, Mecanismo para la Recuperación y la Resiliencia (MRR), COST Action PERMEDIK CA21165, supported by COST (European Cooperation in Science and Technology); PREVENTCKD Consortium Project ID: 101101220 Programme: EU4H DG/Agency: HADEA. Raymond Vanholder is advisor to AstraZeneca, Glaxo Smith Kline, Fresenius Kabi, Novartis, Kibow, Baxter, Nipro, Fresenius Medical Care and Nextkidney. Gabriele Donati has received consultancy fees from Medtronic, speaker fees from Mozarc Medical, Fresenius Medical Care, BBraun. He also received grants from Nipro and Alexion. Karin Gerristen has received consultancy fees from Nextkidney. KG has received funding from the Dutch Growth Fund program NXTGEN HIGHTECH. Mary Lou Wratten is a full-time employee of Mozarc Medical/Bellco. Brett Duane has received consultancy or speaker fees from Proctor and Gamble, Tepe, private dental clinics, as well as other dental companies. There are no other competing interests. Ethical approval: It does not apply to the present manuscript. Informed consent: It does not apply to the present manuscript.

References

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