Kidney care can save lives while adding to pollution, waste, and heavy resource use. This paper argues that the treatment keeping people alive also needs a climate plan. Healthcare is among the most polluting economic sectors, accounting for 5.2 percent of global greenhouse gas emissions, while also causing substantial water, air, and soil pollution, using fresh water, creating waste, and consuming large amounts of energy.

Within healthcare, kidney care is a major polluter as well as a major consumer of resources. That is the problem this discussion starts with. The Forum examined the impact of the environment on kidney health, and the impact of kidney replacement treatments on the environment.

The concern runs in both directions. It focused especially on reducing the environmental footprint of kidney care, especially dialysis, by cutting waste and resource use, and on the possible role of the European Union in supporting sustainable healthcare.

These challenges point to an urgent shift in kidney care, with greater emphasis on screening, prevention, and transplantation rather than relying only on long-term treatment. The proposed shift in kidney care includes a heightened focus on screening, prevention, and transplantation.

It also calls for dialysis systems that use less water and energy, while allowing polymer materials to be reused or recycled instead of simply discarded. Among current kidney replacement treatments, transplantation can have a much lower environmental impact than haemodialysis: its impact has the potential to be 90 to 95 percent less.

But transplantation is still an insufficiently used option for reducing the environmental impact of kidney disease care, and in most European countries, organ-transplantation plans have not met their targets efficiently. The paper points to transplantation plans in Spain and the United Kingdom as examples governments may learn from, while also taking transplantation’s financial benefits into account.

Transplantation is preferred for patients and the environment, but not everyone can receive one. Dialysis will therefore remain the most common treatment for kidney failure in the near future, making sustainable innovation in dialysis crucial.

The dialysis filter adds considerably to treatment costs and environmental burden, and throwing away single-use filters may create many tonnes of medical waste. Possible improvements include safe filters that can be reused for the same patient, reuse of the liquid normally discarded as wastewater, and smaller, highly mobile systems that could avoid needles and last for several years.

Moving sustainable kidney-care innovation forward will require funding through EU financing mechanisms such as the Innovative Health Initiative, while EU production could create a strong export position. The European Union should play a central role by directing funding toward innovative kidney-care research through its financing mechanisms.

The Forum found broad agreement among different groups in kidney health that the European Union needs a more sustainable approach to kidney care, with commitment from policymakers through policies, projects, and initiatives. The shared priorities were to prevent chronic kidney disease, improve organ donation and transplantation, encourage environmentally responsible treatment innovation, and address the substantial environmental impact of managing kidney disease.

The clearest path is to prevent kidney disease, make transplantation more available when suitable, and redesign dialysis to use less water, energy, and disposable material. That could benefit patients, health systems, and the environment together.