Dialysis is one of the most resource-intensive therapies but patients with kidney failure have no other option, except for a kidney transplant.
Nephrologists are trying to quantify the waste as they advocate for environmentally sustainable kidney care, noting the lifesaving therapy generates hundreds of litres of wastewater at least three times a week per patient, along withvast amounts of carbon emissions and single-use plastic.
WHAT WASTE IS GENERATED BY DIALYSIS?
Kidney care waste includes tubing that carries a patient's blood, usually from their arm, to a dialysis machine where it is cleaned of toxins. A second tube returns the blood to the body. Plastic jugs, plastic packaging, cardboard and needles are part of the waste. Some biohazard waste containing blood takes more resources to landfill, and patients who do at-home dialysis sometimes have to pay for extra garbage at the curbside.
HOW IS THE WASTE DISPOSED?
There is no national recycling program for dialysis waste. Some dialysis clinics clean the tubing while others have it shipped out for incineration. Blood-soaked waste must be disinfected before it is landfilled, costing more dollars and energy.
HOW ARE NEPHROLOGISTS TRYING TO REDUCE WASTE?
The Canadian Society of Nephrology iscalling for primary care providers to promote healthy living so conditions including high blood pressure and diabetes don't lead to kidney failure, requiring dialysis. They also want patients to have greater access to kidney transplants, especially from living donors, to reduce the need for dialysis.
The society formed a sustainability committee that is trying to develop a "carbon emissions calculator" that would help caregivers and patients measure the amount of waste that is generated from dialysis
It also wants administrators, governments and industry to help come up with solutions. And they are getting feedback from patients.
HOW DOES WASTE FROM AT-HOME DIALYSIS AFFECT PATIENTS?
Nephrologists say many patients are morally distressed by the high volume of waste their therapy generates.
They say a lack of recycling options forces patients to leave their garbage at the curb and there's often so much that they mustpay for extra bags.
In some cities, patients can take some of the waste to private recyclers but saline bags used for each dialysis sessionare often rejected.
HOW MANY CANADIANS NEED DIALYSIS?
More than 20,000 people have clinic and home-based dialysis, according to nephrologist Dr. Caroline Stigant.
Nephrologists say that number is increasing.
WHAT IS THE CONNECTION BETWEEN CLIMATE CHANGE AND KIDNEY DISEASES?
Extreme heat from climate change can lead to dehydration and risk of kidney diseases, and the intense use of resources from dialysis contributes to climate change.
This report by The Canadian Press was first published May 18, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
Camille Bains, The Canadian Press
