Geelong Hospital, Barwon Health, Geelong, Victoria, Australia.
Nephrology (Carlton). 2010 Jun;15(4):448-53. doi: 10.1111/j.1440-1797.2009.01255.x.
Natural resources are under worldwide pressure, water and sustainable energy being the paramount issues. Haemodialysis, a water-voracious and energy-hungry healthcare procedure, thoughtlessly wastes water and leaves a heavy carbon footprint. In our service, 100 000 L/week of previously discarded reverse osmosis reject water--water which satisfies all World Health Organisation criteria for potable (drinking) water--no longer drains to waste but is captured for reuse. Reject water from the hospital-based dialysis unit provides autoclave steam for instrument sterilization, ward toilet flushing, janitor stations and garden maintenance. Satellite centre reject water is tanker-trucked to community sporting fields, schools and aged-care gardens. Home-based nocturnal dialysis patient reuse reject water for home domestic utilities, gardens and animal watering. Although these and other potential water reuse practices should be mandated through legislation for all dialysis services, this is yet to occur. In addition, we now are piloting the use of solar power for the reverse osmosis plant and the dialysis machines in our home dialysis training service. If previously attempted, these have yet to be reported. After measuring the power requirements of both dialytic processes and modelling the projected costs, a programme has begun to solar power all dialysis-related equipment in a three-station home haemodialysis training unit. Income-generation with the national electricity grid via a grid-share and reimbursement arrangement predicts a revenue stream back to the dialysis service. Dialysis services must no longer ignore the non-medical aspects of their programmes but plan, trial, implement and embrace 'green dialysis' resource management practices.
自然资源正面临全球压力，水和可持续能源是首要问题。血液透析是一种耗水量大、能源消耗高的医疗程序，它浪费水且留下了沉重的碳足迹。在我们的服务中，每周有 10 万升以前被丢弃的反渗透 reject 水——这些水符合世界卫生组织所有饮用水标准——不再被浪费掉，而是被收集再利用。来自医院透析单元的 reject 水为高压锅提供蒸汽，用于仪器消毒、病房厕所冲洗、看管员站和花园维护。卫星中心的 reject 水则用罐车运往社区运动场地、学校和养老院花园。家庭夜间透析患者将 reject 水用于家庭日常用水、花园和动物浇水。尽管所有透析服务都应该通过立法强制实施这些和其他潜在的水再利用实践，但这尚未实现。此外，我们现在正在试点使用太阳能为家庭透析培训服务中的反渗透设备和透析机供电。如果之前有尝试过，那么这些尝试尚未被报道过。在测量了两种透析过程的电力需求并对预计成本进行建模后，一个计划已经开始启动，即将所有与透析相关的设备都通过太阳能供电，该计划应用于一个有三个站点的家庭血液透析培训单元。通过电网共享和报销安排从国家电网获取收入，预计将有资金流回流到透析服务。透析服务不能再忽视其计划的非医疗方面，而是要规划、试验、实施和接受“绿色透析”资源管理实践。
