DIALYSIS FLUID MANAGEMENT – LET'S MAKE DIALYSIS GREENER

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DIALYSIS FLUID MANAGEMENT – LET'S MAKE DIALYSIS GREENER
Jacek
Zawierucha
Wojciech Marcinkowski wojciech.marcinkowski@fmc-ag.com Fresenius Nephrocare Polska sp. z o.o. Medical Office Poznan
Maciej Malyszko jolmal@poczta.onet.pl Warsaw Medical University Nephrology and Dialysis Warszawa
Jacek Malyszko jackmaly@poczta.onet.pl Medical University of Bialystok Nephrology and Dialysis Bialystok
Jolanta Malyszko jolmal@poczta.onet.pl Warsaw Medical University Nephrology, Dialysis and Transplantation Warszawa
 
 
 
 
 
 
 
 
 
 
 

Consumption of water and electricity as well as massive production of medical waste makes dialysis one of the most environmentally polluent medical intervention. Blood purification - life saving procedure - makes significant threat for our environment and paradoxally causes additional risk factors for population health.

One of crucial element of taking care on environmental impact  dialysisis dialysis fluid management – rational flow during HD session as well as way of preparation and delivery. Dialysis fluid may be produced from liquid concentrates or dry/semi-dry powders to be diluted on place.

The aim of the study is environmental impact assessment of different ways of delivery dialysis concentrates.

Three widely used ways of dialysis concentrates management has been compared in terms of carbon footprint generated during transportation, needed storage room, and the workload to be carry by HD center staff.

For comparison hypothetical dialysis center treated 120 HD patients distanced 100 km from supplier warehouse has been used.

Using liquid concentrates delivered in plastic canisters is least effective and most costly (considering storage and workload) way of dialysis fluid delivery. Generated carbon footprint is four times higher than  in case of the most environmental friendly dry powder transported in carton boxes. Additionally containers with liquid acid/bicarbonate components require the biggest storage space (3-2 bigger than in case dry ones) and unneccessary workload – HD center staff has to carry 75 thousand kilos of concentrate from storage to dialysis machines yearly. 

Dry and semi-dry compounds require smaller space for storage and generate significantly smaller carbon footprint. As the modern fully automated mixing devices are in place, the human work is limited to several control activities with reduced to minimum physical work (carrying, stacking in warehouse etc.). 

Even small change in HD procedures can cause dialysis more environmental friendly and help to preserve natural resources. Investment in modern, automated devices for dialysis concentrates production in place is one of the step to make dialysis greener.

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