Need for life cycle assessment of pharmaceuticals for kidney healthcare.

IF 2.2 4区 医学 Q2 UROLOGY & NEPHROLOGY
Kei Nagai, Keisuke Nansai
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Abstract

Purpose: Global warming is a known risk factor for chronic kidney disease (CKD), and both progression of the disease and its treatment place a burden on the environment. Life cycle assessment (LCA) is an established method for evaluating the global impact of manufactured products, from materials' procurement to disposal. We aimed to examine available reports of its application to pharmaceuticals.

Methods: A narrative review focused on LCA studies of any pharmaceuticals according to disease area.

Results: We identified the drug types used for treatment of 13 disease areas described in 51 previous LCA studies, classified using the MIDAS database. Among the drug types, anesthetics, inhalants, and antibiotics have received the most attention. However, LCA studies are lacking for the wide range of pharmaceuticals used in kidney healthcare, in the fields of dialysis therapy, treatment of end-stage kidney disease, and associated cardiovascular, metabolic, and endocrine diseases.

Discussion: As the proportion of the population affected by CKD increases, there is a particular urgency for LCA research into drugs administered for their kidney protective effects, such as renin--angiotensin system inhibitors and sodium-glucose cotransporter 2 inhibitors. As sustainable practices in drug production and the ability to identify and choose effective drugs with low environmental impact require comprehensive LCA data, clinical physicians and pharmacists involved in kidney healthcare should collaborate with pharmaceutical companies to develop an LCA research system . Incorporating rating of environmental burden of each drug into daily practice is desirable for achieving sustainable kidney healthcare and reducing its environmental impacts.

肾脏保健药品生命周期评估的需求。
目的:全球变暖是慢性肾脏疾病(CKD)的已知危险因素,疾病的进展和治疗都会给环境带来负担。生命周期评估(LCA)是一种成熟的方法,用于评估从材料采购到处置的制成品的全球影响。我们的目的是审查其应用于药品的现有报告。方法:对不同病区药物的LCA研究进行综述。结果:我们确定了先前51项LCA研究中描述的用于治疗13个疾病领域的药物类型,使用MIDAS数据库进行分类。在药物种类中,麻醉药、吸入剂和抗生素最受关注。然而,对于肾脏保健、透析治疗、终末期肾脏疾病治疗以及相关的心血管、代谢和内分泌疾病领域中广泛使用的药物,缺乏LCA研究。讨论:随着受CKD影响的人群比例的增加,对肾素-血管紧张素系统抑制剂和钠-葡萄糖共转运蛋白2抑制剂等具有肾脏保护作用的药物进行LCA研究尤为迫切。由于药物生产的可持续实践和识别和选择低环境影响的有效药物的能力需要全面的LCA数据,参与肾脏保健的临床医生和药剂师应该与制药公司合作开发LCA研究系统。将每种药物的环境负担评级纳入日常实践是实现可持续肾脏保健和减少其环境影响的理想选择。
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来源期刊
Clinical and Experimental Nephrology
Clinical and Experimental Nephrology UROLOGY & NEPHROLOGY-
CiteScore
4.10
自引率
4.30%
发文量
135
审稿时长
4-8 weeks
期刊介绍: Clinical and Experimental Nephrology is a peer-reviewed monthly journal, officially published by the Japanese Society of Nephrology (JSN) to provide an international forum for the discussion of research and issues relating to the study of nephrology. Out of respect for the founders of the JSN, the title of this journal uses the term “nephrology,” a word created and brought into use with the establishment of the JSN (Japanese Journal of Nephrology, Vol. 2, No. 1, 1960). The journal publishes articles on all aspects of nephrology, including basic, experimental, and clinical research, so as to share the latest research findings and ideas not only with members of the JSN, but with all researchers who wish to contribute to a better understanding of recent advances in nephrology. The journal is unique in that it introduces to an international readership original reports from Japan and also the clinical standards discussed and agreed by JSN.
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