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. 2025 Sep 22:27:e73942.
doi: 10.2196/73942.

Establishing a Net-Zero Emissions Kidney Care Center: A Model Proposal for Taiwan

Mei-Yi Wu #  1   2   3 , Wei-Cheng Lo #  3   4   5 , Min-Kuang Tsai  1   3 , Yuan-Leng Lin  1   3   5 , Yih-Giun Cherng  6   7 , Ming-Che Lee  8   9 , Mai-Szu Wu  1   2   3
Affiliations

Establishing a Net-Zero Emissions Kidney Care Center: A Model Proposal for Taiwan

Mei-Yi Wu et al. J Med Internet Res. .

Abstract

Green nephrology has emerged as a crucial strategy to address the health care sector's role in the climate crisis, particularly due to the high carbon intensity of dialysis-related services. Aligned with global net-zero commitments, sustainable kidney care can reduce environmental impact while maintaining high standards of patient care. This viewpoint paper proposes a net-zero carbon emissions kidney care center model to address global climate change challenges and advance health care sustainability goals. Based on the United Nations Sustainable Development Goals, we developed a 4D framework: digital transformation, low-carbon health care, circular economy, and preventive medicine. The digital transformation dimension features a precision kidney health system integrating acute and chronic kidney injury digital care models. The low-carbon health care dimension focuses on increasing the rates of kidney transplantation and choosing optimal dialysis modality. The circular economy dimension involves dialysis wastewater recycling, repurposing of medical materials, and integration of renewable energy into facility operations. The preventive medicine dimension incorporates telehealth education, behavioral interventions, and health inequality improvements. This net-zero carbon emissions kidney care model represents an environmental, social, and governance approach to ensuring implementation and continual improvement. It also provides actionable steps for implementing sustainable kidney care and serves as a reference model for net-zero emissions health care systems.

Keywords: circular economy; digital transformation; disease prevention; green nephrology; net-zero carbon emissions; sustainable kidney care.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Conceptual framework of the proposed net-zero emissions kidney care center, aligned with the United Nations’ SDGs. This figure illustrates a multilayered framework for sustainable kidney care, with a kidney-shaped core representing SDG 13 (Climate Action) and the goal of net-zero emissions. Four strategic dimensions extend outward: (1) digital transformation (SDGs 3 and 4) for improved health care and education, (2) low-carbon health care strategies (SDG 3) for sustainable practices, (3) circular economy (SDGs 7 and 12) for renewable energy and responsible resource use, and (4) disease prevention (SDGs 4, 10, and 17) for equitable care and global collaboration. The 3 concentric layers at the bottom represent scope 1 (direct), scope 2 (indirect), and scope 3 (indirect) emissions, offering a structured approach to emission tracking and reduction. SDG: Sustainable Development Goal.
Figure 2
Figure 2
Digital transformation in kidney care: a comprehensive system and service model. The figure illustrates the integration of digital health solutions and innovative service models for kidney care. (A) Comprehensive kidney health digital system incorporating an EMR, a PACS, and an HIS, connected to specialized modules, including a CKD map system, an AKI tracking system, and a dialysis management platform. (B) Innovative AKI service model featuring 4 key components: AKI eAlert system, nephrology care team collaboration, point-of-care services, and individualized follow-up plans. AKI: acute kidney injury; AKD: acute kidney disease; APD: automated peritoneal dialysis; CKD: chronic kidney disease. EMR: electronic medical record; HIS: hospital information system; PACS: picture archiving and communication system.
See this image and copyright information in PMC

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