Emanuele De Simone, Marco Carmelo Morrone, Ece Izel Tatarhan, Marco Pozzato, Dario Roccatello, Roberta Fenoglio, Savino Sciascia
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引用次数: 0
Abstract
Background: the environmental impact of healthcare is a growing concern, and nephrology, particularly dialysis, is a resource-intensive field. Dialysis involves high energy use, water consumption, significant waste generation, and transport-associated emissions. However, the extent to which "green" dialysis practices have been implemented remains largely unexplored.
Methods: A comprehensive survey assessing the adoption of sustainable practices in dialysis covering water, energy, waste, transport and procurement policies was distributed through the European Rare Kidney Disease Reference Network (November 2024 to January 2025). The questionnaire covered key sustainability domains, including water and energy management, waste reduction, transport, and procurement policies. A "Green Score" was developed to quantify the implementation of eco-friendly initiatives. Additionally, a patient survey was conducted to evaluate perceptions of dialysis-related environmental impact and willingness to act.
Results: A total of 34 nephrology centers (43% response rate) participated. The mean Green Score indicated that only 39.4% of achievable sustainability measures were in place. Despite widespread awareness, only 26.5% of centers had formal sustainability strategies, 17.6% had dedicated "Green Teams," and just 12.1% utilized measurable indicators to track interventions. Water reuse systems were absent. Plastic recycling programs were present in 79.4% of centers, yet waste-saving initiatives were rare. Notably, the presence of a Green Team was significantly associated with higher Green Scores (P < .05). Patient responses (n = 45) revealed strong interest in sustainability, with 95.6% willing to take action.
Conclusions: This study highlights critical gaps in sustainable dialysis practices across European nephrology centers. Despite interest, implementation remains limited. The strong association between Green Teams and sustainability scores highlights the need for formalized institutional efforts. Given the significant ecological footprint of dialysis, urgent action is required to integrate sustainable strategies into routine nephrology care.
背景：医疗保健对环境的影响日益受到关注，肾病学，特别是透析学，是一个资源密集型领域。透析涉及高能耗、水消耗、大量废物产生和运输相关排放。然而，“绿色”透析实践的实施程度在很大程度上仍未得到探索。方法：通过欧洲罕见肾病参考网络（2024年11月至2025年1月）进行全面调查，评估透析中可持续实践的采用情况，包括水、能源、废物、运输和采购政策。调查问卷涵盖了关键的可持续发展领域，包括水和能源管理、减少废物、运输和采购政策。制定了“绿色评分”，以量化环保措施的实施情况。此外，还进行了一项患者调查，以评估对透析相关环境影响的看法和采取行动的意愿。结果：共有34家肾科中心参与，反应率43%。平均绿色得分表明，只有39.4%的可实现的可持续发展措施到位。尽管意识广泛，但只有26.5%的中心有正式的可持续发展战略，17.6%的中心有专门的“绿色团队”，只有12.1%的中心使用可测量的指标来跟踪干预措施。没有水再利用系统。79.4%的中心有塑料回收项目，但节约垃圾的举措很少。值得注意的是，绿色团队的存在与更高的绿色得分显著相关（P n = 45），显示出对可持续发展的强烈兴趣，95.6%的人愿意采取行动。结论：本研究强调了欧洲肾脏学中心可持续透析实践的关键差距。尽管有兴趣，但实施仍然有限。绿色团队和可持续性得分之间的紧密联系凸显了正式制度努力的必要性。鉴于透析的显著生态足迹，需要采取紧急行动，将可持续战略纳入常规肾脏病护理。
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About the Journal
Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.
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