Environmental Sustainability in Dialysis Units: A Scoping and Integrative Review of Challenges and Innovations in Nephrology

Background and Aims: The global rise of chronic kidney disease (CKD) has led to a rapid expansion of dialysis services, which, although life-saving, are associated with substantial environmental costs. This study aims to analyze the environmental impacts of dialysis therapies and identify pathways toward more sustainable practices. Methods: This study conducts a comprehensive and integrative literature review on research in renal replacement therapy, adopting the PRISMA-ScR procedure to analyze papers published between 2005 and 2023. Results: The literature primarily focuses on four environmental dimensions: carbon emissions, water consumption, energy use, and waste generation. Dialysis therapies— particularly hemodialysis—are resource-intensive and contribute significantly to environmental degradation though repeated treatments, transportation requirements, and high consumption of materials and energy. Conclusions: Sustainable dialysis can be promoted through the adoption of green technologies, improved waste management, and policies focused on energy and resource efficiency. While current practices are environmentally demanding, feasible strategies exist to reduce their ecological footprint and align nephrology care with global sustainability goals.