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Hemodialysis services consume hundreds of liters of water and generate tons of plastic waste, significantly contributing to environmental impact through substantial water consumption and massive plastic waste generation, both contributing to the global environmental footprint. With an estimated three million maintenance dialysis patients worldwide, a doubling of this number is projected by 2030, potentially exceeding 7 million individuals with chronic kidney disease on dialysis. In developed countries, in the practice of conventional hemodialysis, occurring on a 4-hour weekly regime, each patient consumes approximately 500 liters of water and generates, per session, about 2,500 kg of high-quality infectious plastic waste, including lines, dialyzers, biodegradable bags, concentrate bottles, syringes, among other items. These wastes are destined for landfills or incineration, totaling around 400 kg of polluting plastic waste per patient per year. On a global scale, considering an average estimate of 2.5 million dialysis patients worldwide, the total amount of generated waste approaches 1 million tons. Given the global increase in the prevalence of kidney diseases and the demand for nephrological treatments, it becomes imperative to seek more sustainable approaches to renal care.
Observational study retrospectively evaluating data on water consumption (in mm³), waste production, and the use of hemodialysis supplies (in kg) over the past 12 months, from August 01, 2022, to July 30, 2023. The study was conducted at a single hybrid-funded hemodialysis center (90% public and 10% private) comprising 234 patients (average over the last 12 months) in the city of Teresina, Piauí a low-middle-income state in Brazil. The center exclusively employs automated filter reutilization for this procedure.
Over the course of a year, a dialysis clinic utilized 10,325,000 liters of water (equivalent to two Olympic-sized swimming pools) and generated 6.6 tons of solid waste. Hemodialysis supplies totaled 62,678 units, including 57,258 needles, 2,752 filters, and 2,668 kit lines. Each patient annually contributed to 44,070 liters of water consumption, generating 28.53 kg of solid waste, and consuming 344.36 units of supplies (comprising 321.22 needles, 11.75 filters, and 11.39 kit lines). In individual hemodialysis sessions, each patient consumed an average of 382 liters of water, generated 0.25 kg of waste, and used 2.7 units of supplies.
Conclusions
This study reinforces the growing concern regarding hemodialysis services, emphasizing not only the benefits for patients but also the considerable adverse impacts on the environment. The significant water consumption and massive waste production, which align with data found in the literature, underscore the urgency of adopting measures to make these treatments more sustainable. The need for further research and innovative studies on the development of more environmentally conscious hemodialysis techniques becomes evident in the current scenario. Such a sustainable approach would not only alleviate the environmental impact but also promote efficiency and environmental responsibility in renal care provision.