Dr Ben Talbot1,2, Dr Katherine Barraclough3,4, Professor John Knight1,2, Dr Susan Blair5, A/Professor Forbes McGain6,7, A/Professor Rosemary Masterson3,4, Mr Richard Knight5, A/Professor Craig Nelson4,8,9, Professor Stephen McDonald10,11,12, Dr Scott McAlister6,7
1The George Institute For Global Health, , Australia, 2University of New South Wales, , Australia, 3Department of Nephrology, Royal Melbourne Hospital, , Australia, 4Department of Medicine, University of Melbourne, , Australia, 5Department of Renal Medicine, University Hospital Geelong, , Australia, 6Departments of Anaesthesia and Intensive Care Medicine, Western Health, Footscray, Australia, 7Department of Critical Care, Faculty of Medicine, University of Melbourne, , Australia, 8Department of Nephrology, Western Health, Sunshine, Australia, 9Western Health Chronic Disease Alliance, Western Health, , Australia, 10ANZDATA Registry, South Australia Health and Medical Research Institute, , Australia, 11Central Adelaide Renal and Transplantation Service, Central Adelaide Local Health Network, , Australia, 12Adelaide Medical School, University of Adelaide, , Australia
Biography:
Ben Talbot is a nephrologist and researcher based in the Cardiovascular Division of The George Institute for Global Health. His research includes cardiovascular and kidney disease and environmental sustainability within healthcare and research. He has worked clinically in both Australia and the UK and completed a PhD at University of New South Wales focusing on improving outcomes in global chronic kidney disease.
Aim:
To evaluate and compare the carbon footprints of in-centre haemodialysis, home haemodialysis (HHD), automated peritoneal dialysis (APD), and continuous ambulatory peritoneal dialysis (CAPD) in an urban Australian setting.
Background:
As the health impacts of climate change intensify, the healthcare sector faces growing pressure to minimise its carbon footprint. Achieving this goal requires understanding of the carbon impact of widely used medical treatments. Whilst it is increasingly recognised that dialysis programs have a disproportionately large carbon footprint, to date, no studies have compared the carbon footprints of different dialysis modalities.
Methods:
Attributional process-based life cycle assessment methodology was used to identify the sources and extent of carbon emissions for all dialysis modalities provided by the Royal Melbourne Hospital Kidney Care Service, Melbourne, Victoria, Australia. Carbon emissions in kilogram carbon dioxide equivalents (kg CO2e) were calculated for the annual provision of dialysis to a single patient for each modality.
Results:
In-centre haemodialysis had the highest annual per patient carbon impact, at 4,814 kg CO2e. In comparison, emissions from HHD were 41% lower (2,938 kg CO2e), APD 29% lower (3,339 kg CO2e), and CAPD 59% lower (1,969 kg CO2e). Across all four modalities, consumables were the largest source of emissions. For in-centre haemodialysis, patient travel was the main factor contributing to its higher carbon footprint relative to home-based dialysis options.
Conclusion:
In-centre haemodialysis has a substantially higher carbon footprint than all home dialysis options, supporting prioritisation of home dialysis when feasible and appropriate for individual patients.
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