Green dialysis: environmentally sustainable care, growth, and innovation: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference

Abstract

Hemodialysis, hemodiafiltration, and peritoneal dialysis are among the most resource-intensive medical therapies, owing to their high energy and water consumption, heavy reliance on disposable materials, and frequent, recurring delivery. Although "green dialysis" initiatives have been adopted in some regions, broader implementation is needed, together with the development of new technologies and care models to further mitigate the environmental impact of dialysis. In April 2025, Kidney Disease: Improving Global Outcomes (KDIGO) held the Controversies Conference on Green Dialysis: Environmentally Sustainable Care, Growth, and Innovation. Participants included physicians, nurses, patients, and engineers who examined how existing hemodialysis (in-center and home) and peritoneal dialysis practices might be optimized to promote environmental sustainability. Additionally, opportunities for green innovations in dialysis procedures and technologies were identified. Recognizing the need for urgent and coordinated action among patients, clinicians, and organizations, participants also discussed how industry, policy, and regulations could support embedding environmental sustainability within dialysis care.

Keywords: environment; green dialysis; green nephrology; life cycle assessment; sustainability.