A/Prof. Kelly Lambert1,2, Ms Montana Kostas1,2, Dr Sadia Jahan3
1University of Wollongong, Wollongong, Australia, 2Kidney Lifestyle Research Group, Wollongong, Australia, 3Royal Adelaide Hospital, Adelaide, Australia
Biography:
Kelly Lambert is a Dietitian and Associate Professor of Nutrition and Dietetics at the University of Wollongong, Australia. Her research interests and values are supporting people with kidney disease to live better lives.
Aim:
To map the climate footprint of dialysis treatments and explore carbon reporting completeness in existing literature.
Background:
Dialysis services are recognised hotspots for carbon emissions and costly healthcare spending. The carbon footprint of this resource intense treatment for kidney failure has not been comprehensively evaluated
Methods:
Registered scoping review searching PubMED, Google Scholar, Scopus, Business Source using the population (users of dialysis machines), concept (climate footprint metrics) and context (machines sold worldwide) format, and searching of grey literature. Articles were screened by two reviewers and one extracted the data.
Results:
Initial searches identified1200 articles and 168 underwent full text screening. A total of 40 papers were included in the final analysis, with 18 countries represented and one study of 10 countries. Studies were conducted between 2009-2025. The range of estimates for automated peritoneal dialysis (PD) (n=16) indicated a climate footprint of between 2.350 – 12.9 tonnes per annum (pa) of CO2 equivalents (CO2e). Estimates for continuous ambulatory PD (n=21) were from 1.455 – 2.716 tonnes pa of CO2e. Estimates for haemodialysis (HD) (n=42) suggested total greenhouse gas emissions of 3.139 – 10.2 tonnes of CO2e pa and 125-488L of water per HD treatment. Estimates for Home HD (n=16) ranged from 1.8 – 7.2 tonnes pa of CO2e. Variability in estimates for haemodialysis were related to treatment type, intensity and duration. All estimates varied in the depth of reporting and few utilised measures from life cycle analyses.
Conclusions:
Additional life cycle analyses and standardised reporting are required to improve the precision of estimates. Limited information on the climate footprint of all available dialysis machines prevents informed decision making and implementation of strategies to address climate change.
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