Estimation of environmental impact of dialysis therapy to establish sustainable treatments for chronic kidney disease

Chronic kidney disease (CKD) presents not only a major public health challenge but also a significant environmental burden, particularly in countries like Japan where dialysis is widely used. Associate Professor Kei Nagai of the University of Tsukuba is leading efforts in the emerging field of green nephrology, aiming to align kidney care with environmental sustainability. His research focuses on estimating the carbon footprint of dialysis treatments and identifying practical interventions to reduce their environmental impact. Drawing on personal experiences during the 2011 Great East Japan Earthquake and international collaborations, Nagai highlights the importance of life cycle assessments (LCA), awareness campaigns, and educational reforms to integrate sustainability into nephrology. He advocates for combining peritoneal dialysis with haemodialysis to improve quality of life and reduce strain on limited medical resources. Furthermore, Nagai calls for better data transparency from pharmaceutical companies and tailored healthcare investment strategies that consider Japan’s ageing and declining population. Emphasising that sustainable CKD care must balance medical efficacy with environmental costs, his work supports the development of greener dialysis technologies and hospital systems optimised for reduced water, energy, and plastic waste. Ultimately, Nagai envisions a healthcare system in which environmental impact metrics play a central role in clinical and policy decisions, underscoring the urgent need for more comprehensive research and systemic change in how kidney disease is treated.