Many strategies enabling us to optimize kidney care may also be planet friendly.

Kidney replacement therapy is one of the most energy-consuming and waste-producing medical treatments. Reducing the need of dialysis is therefore an environmentally friendly choice. However, preferring prevention, lifestyle-related interventions and patient education to drugs is time consuming, and most physicians are already overburdened by the many demands of routine clinical practice. In this mini review, we discuss the role that could be played by prevention, diet, and nonpharmacologic interventions in reducing the impact of care of chronic kidney disease and kidney replacement therapy. Although evaluating the environmental impact of chronic kidney disease and kidney replacement therapy is extremely complicated, the need for rethinking all the steps in current nephrology practice to preserve our planet's health is urgent, and shifting from a "drug prescription" model to a "time prescription" one would benefit both our patients and the environment.