{
  "abstract": "Rationale & objective\n\nHemodialysis (HD) is a resource-intensive treatment associated with high environmental impact. This study aimed to quantify the environmental burden of HD procurement and waste and identify key contributors to emissions, energy use, and water consumption.Study design\n\nLife cycle assessment study.Setting & participants\n\nData were collected from the Nephrology Dialysis and Kidney Transplant Unit at the University Hospital Policlinico of Modena, Italy. The analysis reflects 1 patient-year of HD treatment.Exposures or predictors\n\nProcurement and life cycle of HD consumables and equipment.Outcomes\n\nGreenhouse gas emissions (kg CO₂-equivalent), primary energy demand (MJ), and water use (m³).Analytical approach\n\nA life cycle assessment was conducted in accordance with the International Organization for Standardization 14040/14044 standards using the OpenLCA software and the Ecoinvent database. Ten key HD products were analyzed across all life cycle stages from raw material extraction to disposal.Results\n\nThe dialyzer and bicarbonate cartridge were the largest contributors, together accounting for ∼70% of total carbon emissions. Additional impacts arose from saline solution, blood tubing, and dialysate bags. Plastic production, transport, and waste incineration were key drivers of environmental burden. Electricity use from HD machine operation also contributed substantially to total energy demand.Limitations\n\nThis study was based on data from a single center and relied on life cycle databases that may not fully capture variability in manufacturing and disposal processes. Some consumables and clinical variations were not included.Conclusions\n\nHD procurement is a major source of environmental impact, largely driven by a small number of high-impact consumables. Targeted strategies including product redesign, reduction of single-use materials, and improved waste management may reduce the environmental footprint of dialysis care.",
  "abstract_shown": true,
  "affiliations": [
    "School of Dental, Child and Public Health, Trinity College Dublin, Ireland.",
    "Department CHIMOMO, University of Modena and Reggio Emilia, Modena, Italy.",
    "Nephrology Dialysis and Kidney Transplant Unit, University Hospital Policlinico of Modena, Modena, Italy.",
    "Universidad Autonoma de Madrid, Spain.",
    "Centre for Sustainable Healthcare, Oxford, United Kingdom.",
    "Mozarc Medical, Mirandola, Italy."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 12,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "James Larkin",
      "orcid": "0009-0007-5152-2414"
    },
    {
      "affs": [
        1
      ],
      "name": "Giulia Ligabue"
    },
    {
      "affs": [
        2
      ],
      "name": "Gaetano Alfano"
    },
    {
      "affs": [
        3
      ],
      "name": "Rodrigo M Cadenas"
    },
    {
      "affs": [
        0
      ],
      "name": "Abass Fehintola"
    },
    {
      "affs": [
        4
      ],
      "name": "Ingeborg Steinbach"
    },
    {
      "affs": [
        4
      ],
      "name": "Aycan Yasar"
    },
    {
      "affs": [
        1
      ],
      "name": "Niccolo Morisi"
    },
    {
      "affs": [
        4
      ],
      "name": "Marta Arias-Guillen"
    },
    {
      "affs": [
        5
      ],
      "name": "Marialuisa Caiazzo"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Gabriele Donati"
    },
    {
      "affs": [
        0
      ],
      "name": "Brett Duane"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/917n3j3pkvy4f.bib",
  "cited_by": 0,
  "doi": "10.1016/j.xkme.2026.101517",
  "fulltext_url": "https://europepmc.org/articles/PMC13694722",
  "id": "917n3j3pkvy4f",
  "issns": [
    "2590-0595"
  ],
  "landing_url": "https://europepmc.org/article/MED/42926757",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2305|Environmental Impact and Sustainability"
    ]
  ],
  "openalex": "W7211878313",
  "pdf_url": "https://europepmc.org/articles/PMC13694722?pdf=render",
  "pmcid": "PMC13694722",
  "pmid": "42926757",
  "published": "2026-09-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/917n3j3pkvy4f.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:18Z",
      "native_id": "MED:42926757",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42926757"
    }
  ],
  "subjects": [
    {
      "field": "earth",
      "origin": "openalex:2305|Environmental Impact and Sustainability",
      "subfield": "environmental-science"
    }
  ],
  "title": "Procurement and Waste in Hemodialysis: A Detailed Life Cycle Assessment to Reduce Environmental Impact.",
  "title_text": "Procurement and Waste in Hemodialysis: A Detailed Life Cycle Assessment to Reduce Environmental Impact.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:21:18Z",
  "url": "https://research.draconitic.com/paper/917n3j3pkvy4f",
  "venue": "Kidney medicine",
  "versions": []
}