Duane Brett, Steinbach Ingeborg, Stancliffe Rachel, Barna Stefi, Cameron David, de Barbieri Ilaria, Noruisiene Edita, Mortimer Frances, Gerritsen Karin, Vanholder Raymond, Donati Gabriele, Alfano Gaetano, Malyszko Jolanta, Ligabue Giulia, Johnston Bridget, Wratten Mary Louise, Caiazzo Marialuisa, Schmid Elisabeth, Ortiz Alberto
Sustainability in Healthcare Lead, Trinity College Dublin, School of Dental Science, Dublin, Ireland.
Centre for Sustainable Healthcare, 8 King Edward Street, Oxford, OX1 4HL, UK.
J Nephrol. 2025 Jan;38(1):87-99. doi: 10.1007/s40620-024-02114-3. Epub 2024 Nov 8.
The European Union (EU)-funded KitNewCare consortium aims to create and manage a comprehensive EU-wide programme focusing on sustainability in Kidney Care. Around 850 million people have chronic kidney disease (CKD) worldwide and by 2030, 6 million will need kidney replacement therapy, mainly haemodialysis. As the world population gets older, projections for the end of the century worsen. From a sustainability perspective, healthcare systems contribute around 5-11% of total carbon emissions. Kidney care is one of the most resource-intensive specialties. In addition to energy, haemodialysis and peritoneal dialysis require transportation of patients and personnel to and from facilities, use large volumes of water and generate significant plastic waste. Overall, current dialysis is not sustainable in the medium term. Primary prevention, early diagnosis and treatment of CKD and transplantation will decrease the need for dialysis, but this will take time and will not prevent the need for dialysis in millions of persons. There is a need to improve knowledge around the environmental and financial cost of kidney care and social and health outcomes of each patient pathway including using holistic tools such as life cycle assessment. This knowledge will allow workflow optimisations, organisational transformations and technological innovations across Europe, learning from different clinical sites. KitNewCare will build a European-wide knowledge base for sustainability in kidney care, develop and introduce a novel 4-factor database for comprehensive impact analysis, implement optimised processes and organisational transformations in four European clinical sites. It will also pilot innovations from small- and medium-sized high-tech enterprises with a focus on kidney care, and establish a network for continuous monitoring, benchmarking, and implementation of sustainable solutions across healthcare sectors. This paper presents the rationale behind selecting kidney disease as a focal point, summarises the current state of knowledge, and outlines the foundational statement underlying KitNewCare's operational framework.
由欧盟资助的KitNewCare联盟旨在创建并管理一项全欧盟范围的综合性计划，重点关注肾脏护理的可持续性。全球约有8.5亿人患有慢性肾脏病（CKD），到2030年，600万人将需要肾脏替代治疗，主要是血液透析。随着世界人口老龄化，对本世纪末的预测更加严峻。从可持续性角度来看，医疗保健系统占总碳排放量的5%-11%左右。肾脏护理是资源最密集的专科之一。除能源外，血液透析和腹膜透析需要运送患者和医护人员往返医疗机构，消耗大量水，并产生大量塑料垃圾。总体而言，目前的透析在中期是不可持续的。CKD的一级预防、早期诊断和治疗以及移植将减少透析需求，但这需要时间，而且无法避免数百万人对透析的需求。有必要提高对肾脏护理的环境和财务成本以及每个患者治疗途径的社会和健康结果的认识，包括使用生命周期评估等整体工具。这些知识将有助于在欧洲各地优化工作流程、进行组织变革和技术创新，从不同的临床场所汲取经验。KitNewCare将建立一个全欧洲范围的肾脏护理可持续性知识库，开发并引入一个新颖的四因素数据库用于全面影响分析，在四个欧洲临床场所实施优化流程和组织变革。它还将试点中小型高科技企业针对肾脏护理的创新，并建立一个网络，用于持续监测、基准评估以及在各医疗保健部门实施可持续解决方案。本文阐述了选择肾脏疾病作为重点的基本原理，总结了当前的知识状况，并概述了KitNewCare运营框架的基本声明。
