Procurement and Waste in Hemodialysis: A Detailed Life Cycle Assessment to Reduce Environmental Impact.
6 affiliations
- 1School of Dental, Child and Public Health, Trinity College Dublin, Ireland.
- 2Department CHIMOMO, University of Modena and Reggio Emilia, Modena, Italy.
- 3Nephrology Dialysis and Kidney Transplant Unit, University Hospital Policlinico of Modena, Modena, Italy.
- 4Universidad Autonoma de Madrid, Spain.
- 5Centre for Sustainable Healthcare, Oxford, United Kingdom.
- 6Mozarc Medical, Mirandola, Italy.
Abstract
Rationale & objective
Hemodialysis (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
Life cycle assessment study.Setting & participants
Data 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
Procurement and life cycle of HD consumables and equipment.Outcomes
Greenhouse gas emissions (kg CO₂-equivalent), primary energy demand (MJ), and water use (m³).Analytical approach
A 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
The 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
This 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
HD 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.
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BibTeX
@article{larkin2026procurement,
title = {{Procurement and Waste in Hemodialysis: A Detailed Life Cycle Assessment to Reduce Environmental Impact.}},
author = {James Larkin and Giulia Ligabue and Gaetano Alfano and Rodrigo M Cadenas and Abass Fehintola and Ingeborg Steinbach and Aycan Yasar and Niccolo Morisi and Marta Arias-Guillen and Marialuisa Caiazzo and Gabriele Donati and Brett Duane},
journal = {Kidney medicine},
year = {2026},
month = sep,
doi = {10.1016/j.xkme.2026.101517},
url = {https://europepmc.org/article/MED/42926757},
note = {CC BY},
}
RIS
TY - JOUR
TI - Procurement and Waste in Hemodialysis: A Detailed Life Cycle Assessment to Reduce Environmental Impact.
AU - James Larkin
AU - Giulia Ligabue
AU - Gaetano Alfano
AU - Rodrigo M Cadenas
AU - Abass Fehintola
AU - Ingeborg Steinbach
AU - Aycan Yasar
AU - Niccolo Morisi
AU - Marta Arias-Guillen
AU - Marialuisa Caiazzo
AU - Gabriele Donati
AU - Brett Duane
PY - 2026
DA - 2026/09/07
JO - Kidney medicine
DO - 10.1016/j.xkme.2026.101517
UR - https://europepmc.org/article/MED/42926757
AB - Rationale & objective Hemodialysis (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 Life cycle assessment study.Setting & participants Data 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 Procurement and life cycle of HD consumables and equipment.Outcomes Greenhouse gas emissions (kg CO₂-equivalent), primary energy demand (MJ), and water use (m³).Analytical approach A 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 The 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 This 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 HD 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.
SN - 2590-0595
ER -