FROM PATIENT CARE TO ENVIRONMENTAL CARE: LARGE SCALE IMPLEMENTATION OF A POLYVINYL CHLORIDE RECYCLING PROGRAM IN PERITONEAL DIALYSIS PATIENTS.

 

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https://storage.unitedwebnetwork.com/files/1099/82adcda9cc137104c177be25415c5dcd.pdf
FROM PATIENT CARE TO ENVIRONMENTAL CARE: LARGE SCALE IMPLEMENTATION OF A POLYVINYL CHLORIDE RECYCLING PROGRAM IN PERITONEAL DIALYSIS PATIENTS.

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Nathan
Berman-Parks
Nathan Berman-Parks nberman9@gmail.com Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubiran Nefrología y Metabolismo Mineral Mexico City Mexico *
Ilana Berman-Parks ilanaber9@gmail.com RE-PVC Managment Mexico City Mexico -
Leticia Georgina Hernández-Bardales repvcmx@gmail.com RE-PVC Managment Mexico City Mexico -
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Renal replacement therapies (RRT) are among the medical interventions with the highest resource consumption and waste generation. It is estimated that around 5 million people worldwide receive RRT, about 10% of that population (approximately 500,000 patients) are treated with peritoneal dialysis (PD). Each PD patient generates on average 1.7 kg of daily waste, more than half of which is composed of polyvinyl chloride (PVC).  When disposed in landfills of PVC releases plasticizers and microplastics and when disposed of by incineration it generates toxic compounds, contributing to environmental contamination and greenhouse gas emissions. We previously demonstrated the feasibility of medical-grade PVC recycling in a  small pilot program involving PD patients in Mexico city.  The objective of the study is to describe the large scale implementation, temporal evolution, and environmental impact of a large scale PVC recycling program involving PD patients in Mexico city, assessing its temporal expansion and measurable outcomes.

PD patients in Mexico city were invited to participate through social media, educational sessions and direct contact at dialysis clinics. Each participant received a dedicated container and instructions for the safe collection of plastic waste derived from their treatment, including dialysate bags and tubing sets (Fig. 1).The collected material was periodically picked up and transported to an industrial recycling facility. There, the waste was manually sorted into PVC and other polymers. The PVC fraction was washed, shredded, and processed in order to be sold to the thermoplastic industry as raw material for the production of plastic products. Data regarding patient participation, total and per patient weight of recovered PVC; and environmental impact was analyzed. Participants of the PVC recycling program in peritoneal dialysis, each provided with a dedicated RE·PVC container for home collection of medical-grade plastic waste.

Between November 2024 (the date of the program start) and August 2025, the number of enrolled patients increased steadily from 12 patient per month to 263 patient/month. Monthly PVC collection grew from 193 kg to 3.3 tons (Fig. 2), reaching a cumulative total of 18 tons during the observation period. The average monthly collection per patient remained stable at approximately 12 kg, indicating consistency in participation. Compared with virgin PVC production, recycling avoided an estimated consumption of 234,000 liters of water, 360,000 kWh of electricity, and 90 tons of CO₂ emissions and prevented 18 tons of PVC waste from ending up in landfills, avoiding contamination from plasticizers and microplastics.

The expansion of the PVC recycling program for PD patients proved feasible and sustainable at scale, with increasing engagement from patients and healthcare providers.Beyond its environmental benefits, the program fostered awareness and patient involvement in sustainability efforts within kidney care. This experience demonstrates that environmental responsibility can be integrated into chronic disease management and provides a replicable model for reducing the ecological footprint of renal replacement therapies in other regions.

Kewords