ePO 12-Circular economy in haemodialysis: integrated strategies to reduce environmental footprint without compromising clinical safety

Introduction

Haemodialysis is a chronic, repetitive and highly resource-intensive therapy, characterized by high water and energy consumption, extensive use of single-use medical devices and significant waste generation. As such, it represents a relevant contributor to the environmental footprint of healthcare systems. Increasing regulatory, environmental and economic pressures call for a transition from linear care models towards approaches based on circular economy principles.

Methods / Approach

This work presents and systematizes circular economy strategies applicable to haemodialysis, organized across five interrelated domains: water, energy, waste, transport and prescription/prevention. Strategies include optimization of water treatment systems, dialysate flow reduction, controlled reuse of reverse osmosis reject water, energy efficiency measures and heat recovery, integration of renewable energy sources, waste reduction and sustainable waste management, logistics optimization, and clinical and organizational approaches such as optimized haemodiafiltration, incremental/decremental dialysis, home therapies, and prevention and early detection of chronic kidney disease.

Results

Available evidence indicates that integrated implementation of these strategies can reduce water and energy consumption, waste generation and the carbon footprint of haemodialysis, without compromising clinical safety or quality of care.

Discussion

Assessment of environmental performance should go beyond simplistic indicators and incorporate risk-based and life-cycle-oriented metrics, in order to reflect real gains and avoid misleading interpretations.

Conclusions

The adoption of circular economy strategies in haemodialysis is feasible, desirable and clinically compatible, representing a transferable model of environmental sustainability best practices within the healthcare sector.